Individual provider Active NPI

Bradley Jay Smith, O.D.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1922000975
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
542 Issued in AZ
Practice address
300 W Clarendon Ave
Ste 150
Phoenix, AZ 85013-3405
Phone
(602) 265-0343
Fax
(602) 265-2809
NPI assigned
Jun 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 542 AZ Primary

Addresses

Primary practice location

300 W Clarendon Ave
Ste 150
Phoenix, AZ 85013-3405

Mailing address

6002 E Hartford Ave
Scottsdale, AZ 85254-5902
Phone (602) 265-5172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050813000021 AZ Practitioner - Optometry 0345234977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
542AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Eye Care PC Optometrist CurrentSince Jan 1, 2001 Accepting new patients
Banner - University Medical Center Phoenix Campus Surgical Specialists Past Accepting new patients

Locations

6343 E Main St
Ste B7
Mesa, AZ 85205
Phone (480) 832-0030

1940 S Country Club Dr
Ste 102
Mesa, AZ 85210
Phone (480) 834-6367

3201 W Peoria Ave
Ste D704
Phoenix, AZ 85029
Phone (602) 843-4844

300 W Clarendon Ave
Ste 150
Phoenix, AZ 85013
Phone (602) 265-0343

Organizations & group practices 2

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1922000975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 E HARTFORD AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545902",
            "telephone_number": "602-265-5172",
            "fax_number": "602-265-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133405",
            "telephone_number": "602-265-0343",
            "fax_number": "602-265-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.