Jeffrey Teddy Smith, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1388 Issued in CO

Practice address

1011 Pearl St
Boulder, CO 80302-5110

Phone

(303) 939-8021

Fax

(303) 939-8025

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Envision BoulderGroup PAC ID 1153211073, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Envision Boulder

  • Optometrist
  • Boulder, CO
  • NPI 1982873543
  Medicare reassignment Care Compare group NPD
• R. Scott Oberbreckling, O.D. LLC

  • Optometrist
  • Boulder, CO
  • NPI 1033204136
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1730229170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025110",
            "telephone_number": "303-939-8021",
            "fax_number": "303-939-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025110",
            "telephone_number": "303-939-8021",
            "fax_number": "303-939-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEFFREY",
        "middle_name": "TEDDY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kaleigh Jane Smith
• Emma Smith
• Forrest J Smith
• Holly Angela Smith, M.A
• Hunter Russell Smith, M.D.
• Jessica Sloan Smith
• Jonathan B Smith, DDS
• Joshua James Smith
• Karissa Marlene Smith, L.A.C. , RN
• Kathleen Cornelius Smith, LPC

• Optometrist in Boulder, CO
• Providers in Boulder, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.