Deactivated NPI 1104828946 Deactivated / Inactive NPI Male Practitioner

Dr. Eddie Alan Smith , OD

Optometrist • Stillwater, OK

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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. Eddie Smith has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 11, 2005

NPI Deactivation Date March 21, 2006

Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Eddie Smith, OD was a registered Optometrist practicing in Stillwater, OK. Throughout an active medical career spanning 1 years, Dr. Smith provided care at the practice location at 617 S MAIN ST until profile deactivation on 2006-03-21.

Historical Medicare Part B clinical services included photography of the retina, established patient complete exam of visual system, established patient outpatient office visit. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

617 S Main St

Stillwater, OK 740744060

Telephone 4053727337

Fax 4053727337

Associated Practice Facility / Clinic

🏢 Dr. Eddie Alan Smith Pllc Facility NPI 1689887994

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Stillwater, OK

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 24.1 Yrs

State Avg: 22.4 Yrs

Regional Practice Density

18 Specialists

Practicing in Stillwater, OK (943 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

37.9% 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 (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92250 Photography of the retina	94	92	$110.97	$36.41
92014 Established patient complete exam of visual system	93	92	$128.00	$118.85
99213 Established patient office or other outpatient visit, typically 15 minutes	36	30	$119.00	$86.52
92202 Extended exam of the back part of the eye with optic nerve drawing	30	26	$36.07	$15.19
92083 Exam of visual field with extended testing	28	24	$110.00	$58.57
92134 Imaging of retina	21	17	$62.00	$35.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92250 Photography of the retina	176	174	$112.00	$42.13
92014 Established patient complete exam of visual system	173	173	$128.00	$119.08
99213 Established patient office or other outpatient visit, typically 15 minutes	84	58	$119.00	$71.29
92202 Extended exam of the back part of the eye with optic nerve drawing	56	42	$36.00	$15.40
92083 Exam of visual field with extended testing	55	42	$110.00	$58.83
92134 Imaging of retina	48	39	$62.00	$36.09
92133 Imaging of optic nerve	15	12	$62.00	$33.25
92004 New patient complete exam of visual system	11	11	$128.00	$128.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92250 Photography of the retina	196	194	$112.00	$47.49
92014 Established patient complete exam of visual system	191	191	$128.00	$120.21
92226 Examination of eye by ophthalmoscope with retinal drawing	126	47	$32.00	$24.40
99213 Established patient office or other outpatient visit, typically 15 minutes	112	78	$119.00	$71.00
92083 Exam of visual field with extended testing	76	57	$110.00	$60.06
92134 Imaging of retina	67	54	$62.00	$36.91
92225 Examination of eye by ophthalmoscope with retinal drawing	36	19	$36.00	$26.53
92133 Imaging of optic nerve	25	18	$62.00	$32.92
92004 New patient complete exam of visual system	14	14	$128.00	$127.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$128.00	$104.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92250 Photography of the retina	218	215	$112.00	$52.81
92014 Established patient complete exam of visual system	210	209	$127.34	$118.08
99213 Established patient office or other outpatient visit, typically 15 minutes	120	86	$118.58	$69.15
92226 Examination of eye by ophthalmoscope with retinal drawing	111	45	$32.00	$23.72
92083 Exam of visual field with extended testing	80	63	$110.00	$59.57
92134 Imaging of retina	68	56	$62.00	$36.94
92225 Examination of eye by ophthalmoscope with retinal drawing	48	24	$36.00	$25.80
92133 Imaging of optic nerve	27	20	$62.00	$33.09
66984 Removal of cataract with insertion of lens	25	16	$300.00	$122.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	22	$128.00	$102.26
92004 New patient complete exam of visual system	16	16	$128.00	$126.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92250 Photography of the retina	202	198	$112.00	$57.74
92014 Established patient complete exam of visual system	184	183	$127.27	$111.39
92226 Examination of eye by ophthalmoscope with retinal drawing	111	42	$32.00	$22.42
99213 Established patient office or other outpatient visit, typically 15 minutes	94	59	$119.00	$66.28
92083 Exam of visual field with extended testing	55	42	$110.00	$56.97
92134 Imaging of retina	38	31	$62.00	$34.81
66984 Removal of cataract with insertion of lens	34	21	$300.00	$115.96
92133 Imaging of optic nerve	27	19	$62.00	$31.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	19	$128.00	$97.44
92004 New patient complete exam of visual system	23	23	$128.00	$124.99

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OK 1168

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1000763810A (OK)

Career & Practice History Timeline

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

11 Historical Events

📍

Updated Practice Location September 14, 2017

Registered at 617 S MAIN ST, STILLWATER, OK 740744060 (Tel: 4053727337)

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Updated Business Mailing Address September 14, 2017

Registered at 617 S MAIN ST, STILLWATER, OK 740744060 (Tel: 4053727337)

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Provider Name / Credentials Updated September 14, 2017

Recorded as EDDIE SMITH, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2017

Optometrist (License #1168 in OK)

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Updated Practice Location February 18, 2014

Registered at 617 S MAIN ST, STILLWATER, OK 740744060 (Tel: 4053727337)

📍

Updated Business Mailing Address February 18, 2014

Registered at 617 S MAIN ST, STILLWATER, OK 740744060 (Tel: 4053727337)

👤

Provider Name / Credentials Updated February 18, 2014

Recorded as EDDIE SMITH, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 18, 2014

Optometrist (License #1168 in OK)

🔄

NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 21, 2006

Record deactivated on March 21, 2006

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Initial NPI Registration & Enumeration August 11, 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: 1104828946

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 11, 2005

Last Update: September 14, 2017

Deactivation Date: March 21, 2006

Sole Proprietor: No

Update or Correct Profile

Mailing Address

617 S Main St

Stillwater, OK 740744060

Phone: 4053727337

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.