Traci L. S. Schmalle-Jacobs, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

594 Issued in HI

Practice address

1131 Kuala Street
C/O the Vision Center
Pearl City, HI 96782

Phone

(808) 455-5650

Fax

(808) 455-5625

NPI assigned

Aug 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Traci L. Schmalle Professional name

Medicare fee-for-service enrollment

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Traci L. Schmalle, O.D., LLC

  • Optometrist
  • Pearl City, HI
  • NPI 1720195399
  Authorized official Same address or phone

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699882324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-348 LELEAKA ST",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967892213",
            "telephone_number": "808-455-5650",
            "fax_number": "808-455-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 KUALA STREET",
            "address_2": "C/O THE VISION CENTER",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "96782",
            "telephone_number": "808-455-5650",
            "fax_number": "808-455-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMALLE-JACOBS",
        "first_name": "TRACI",
        "middle_name": "L. S.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "SCHMALLE",
            "middle_name": "L.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Optometrist in Pearl City, HI
• Providers in Pearl City, HI by specialty
• Optometrist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.