Organization Active NPI

Stephen E Smith MD PA

Doing business as Eye Associates of Fort Myers

  • Ophthalmology Physician
  • Fort Myers, FL
National Provider Identifier
1760442677
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
STEPHEN E SMITH MD PA
Doing business as
Eye Associates of Fort Myers
Practice address
4225 Evans Ave
Fort Myers, FL 33901-9311
Phone
(239) 936-7685
Fax
(239) 936-8683
NPI assigned
Mar 24, 2006
Last updated
Feb 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Mrs. Meghan Lighthall
Title
Administrator
Phone
(239) 939-0413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

4225 Evans Ave
Fort Myers, FL 33901-9311

Mailing address

4225 Evans Ave
Fort Myers, FL 33901-9311
Phone (239) 936-7685

Other identifiers 1

IdentifierTypeStateIssuer
254549700MedicaidFL

Other names 1

  • EYE ASSOCIATES OF FORT MYERS Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SESmithMD@eafm.direct.eyemdemr.com Direct EYE ASSOCIATES OF SOUTHWEST FLORIDA, M.D.,P.A.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000197 FL Part B Supplier - Clinic/Group Practice 8426031964 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Myers, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2054177Eye Associates of Fort Myers4225 Evans Ave, Fort Myers, FL 33901Certificate of waiverFeb 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1760442677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019311",
            "telephone_number": "239-936-7685",
            "fax_number": "239-936-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019311",
            "telephone_number": "239-936-7685",
            "fax_number": "239-936-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN E SMITH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "LIGHTHALL",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-939-0413",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254549700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SESmithMD@eafm.direct.eyemdemr.com",
            "affiliation": "Y",
            "affiliationName": "EYE ASSOCIATES OF SOUTHWEST FLORIDA, M.D.,P.A.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4225 Evans Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339019311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EYE ASSOCIATES OF FORT MYERS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EYE ASSOCIATES OF FORT MYERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.