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Deactivated NPI 1417943598 Deactivated / Inactive NPI Male Practitioner

Dr. Mark W. Smith , OD

Optometrist • St Petersburg, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Mark Smith has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 23, 2005
NPI Deactivation Date May 22, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Mark Smith, OD was a registered Optometrist practicing in St Petersburg, FL. Throughout an active medical career spanning 20 years, Dr. Smith provided care at the practice location at 620 10TH STREET N. until profile deactivation on 2025-05-22.

Historical Medicare Part B clinical services included established patient complete exam of visual system, established patient problem focused exam of visual system, imaging of optic nerve. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

620 10th Street N.

St Petersburg, FL 337051407

Telephone 7278247134
Fax 7278248329
Associated Practice Facility / Clinic
🏢 Sc Physicians Llc Facility NPI 1639478589

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in St Petersburg, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.2 Yrs
State Avg: 22.7 Yrs
Regional Practice Density
57 Specialists

Practicing in St Petersburg, FL (3724 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
60.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
310 301 $299.00 $119.12
92012 Established patient problem focused exam of visual system
115 88 $211.00 $84.42
92133 Imaging of optic nerve
74 74 $87.00 $34.65
92083 Exam of visual field with extended testing
61 56 $150.00 $59.74
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's
56 42 $40.00 $16.09
92004 New patient complete exam of visual system
40 40 $354.00 $141.71
99213 Established patient office or other outpatient visit, typically 15 minutes
36 26 $221.00 $88.38
92250 Photography of the retina
26 26 $88.00 $35.10
92134 Imaging of retina
23 22 $96.00 $38.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
19 19 $312.00 $124.73

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License FL OPC2260

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1386639045

Doctor of Medicine (M.D.)

NPI 1407841596

Doctor of Medicine (M.D.)

NPI 1447788419

Doctor of Optometry

NPI 1821527276

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated May 22, 2025

Record deactivated on May 22, 2025

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Updated Business Mailing Address August 09, 2022

Registered at 620 10TH ST N STE 2C, ST PETERSBURG, FL 337051407 (Tel: 7278247134)

NPI Profile Active February 19, 2016

NPI status registered as active in NPPES database

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Updated Practice Location February 19, 2016

Registered at 620 10TH STREET N., ST PETERSBURG, FL 337051407 (Tel: 7278247134)

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Updated Business Mailing Address February 19, 2016

Registered at PO BOX 12868, ST PETERSBURG, FL 337332868 (Tel: 7275321355)

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Provider Name / Credentials Updated February 19, 2016

Recorded as MARK SMITH, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 19, 2016

Optometrist (License #OPC2260 in FL)

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Initial NPI Registration & Enumeration September 23, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417943598
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 23, 2005
Last Update: February 19, 2016
Deactivation Date: May 22, 2025

Mailing Address

Po Box 12868

St Petersburg, FL 337332868

Phone: 7275321355

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.