Individual provider Active NPI

Bradley James Smith, O.D.

  • Optometrist
  • Wooster, OH
National Provider Identifier
1689670846
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4806/T1648 Issued in OH
Practice address
370 E Milltown Rd Ste B
Wooster, OH 44691-1280
Phone
(330) 345-1551
Fax
(330) 967-0053
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4806/T1648 OH Primary

Addresses

Primary practice location

370 E Milltown Rd Ste B
Wooster, OH 44691-1280

Mailing address

370 E Milltown Rd Ste B
Wooster, OH 44691-1280
Phone (330) 345-1551

Other identifiers 2

IdentifierTypeStateIssuer
410048838OtherOHRAILROAD MEDICARE
2026006MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071212000012 OH Practitioner - Optometry 1052401254 Practice locations: Wooster, OH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

370 E Milltown Rd
Suite B
Wooster, OH 44691-1280
Phone (330) 345-1551

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4806OHMDPsychologist
4806/T1648OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley J. Smith CurrentSince Jul 8, 2002 Accepting new patients
Eye Surgery Consultants Inc. Past Accepting new patients
Ashland Eyecare Inc Optometrist Past Accepting new patients

Locations

370 E Milltown Rd
Ste B
Wooster, OH 44691
Phone (330) 345-1551

370 E Milltown Rd
Wooster, OH 44691
Phone (330) 345-3620

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1689670846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 E MILLTOWN RD STE B",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911280",
            "telephone_number": "330-345-1551",
            "fax_number": "330-967-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E MILLTOWN RD STE B",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911280",
            "telephone_number": "330-345-1551",
            "fax_number": "330-967-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4806/T1648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410048838",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2026006",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.