Adam Richard Smith, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD61217146 Issued in WA

Practice address

450 NW Gilman Blvd Ste 104
Issaquah, WA 98027-2483

Phone

(425) 392-8756

NPI assigned

Feb 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Overlake Eyecare P SGroup PAC ID 4284521170, 5 clinicians

Stephan Cassidy OD PSGroup PAC ID 6507195260, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Overlake Eyecare P S

  • Ophthalmology Physician
  • Bellevue, WA
  • NPI 1770580086

  Optometrist

  Medicare reassignment Care Compare group NPD
• Stephan Cassidy OD PS

  dba Issaquah Vision Source, PS

  • Optometrist
  • Issaquah, WA
  • NPI 1225195431
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1912591884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 189TH PL SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279710",
            "telephone_number": "425-269-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 104",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-392-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ADAM",
        "middle_name": "RICHARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-22",
        "last_updated": "2022-03-05",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006923",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61217146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Slaybaugh, MA, LMHC
• Rachael Sletten, CBT
• Robert Steven Sloan, PT
• Morley Slutsky, MD, MPH
• Tiffany Smith-Fleischman, IBCLC, RLC
• Amy Lee Smith, SLP
• Colin Smith, PH.D.
• Heather K Smith, L.M.P.
• Jazmine Smith
• Julia R Smith, MD

• Optometrist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.