MADELINE SMITH (OD) – Optometrist, NPI 1205516143

MADELINE SMITH (OD) is a healthcare provider. based in Wichita, Kansas. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 2199 (KS). The NPI Number for MADELINE SMITH (OD) is 1205516143

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MADELINE SMITH (OD)
NPI
1205516143
Phone
(316) 686-6063
Address
10531 E 21ST ST N
Enumeration Date
24 July 2023
Last Update Date
24 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6204422577
Graduation Year
2023 (3 years ago)
PAC ID
1355703109
Group Practice PAC ID
6901883313
Professional Enrollment ID
I20230811000216
Address ID
KS670053844AR2508XDRXX307
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

532 OPTOMETRY in KS

Provider Addresses for MADELINE SMITH (OD)

  • 10531 E 21ST ST N

    WICHITA, KS 672063582

    Phone: (316) 686-6063

    Fax: (316) 686-4214

    Type: Mailing

  • 2508 EDGEMONT DR STE 6

    ARKANSAS CITY, KS 670053844

    Phone: (620) 442-2577

    Type: Location

  • 10531 E 21st St N

    Wichita, KS 672063582

    Phone: (316) 686-6063

    Fax: (316) 686-4214

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $129.

Total Amount is formed as General ($129) + Research ($0) + Ownership ($0) = $129.

Last reported payment date: 2024-09-24 • Largest payer in this snapshot: Genentech USA, Inc. ($129).

Total Amount

$129

General + Research + Ownership

Payments

1

Total payment records

General Amount

$129

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Genentech USA, Inc.$129
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230811000216IOptometryKSTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1614$0
92134Imaging of retina1414$0
99204New patient office or other outpatient visit, 45-59 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 67206)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901883313View full group profile
NameSpecialtyState
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS
O P T O M E T R YKS

Reviews

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Frequently asked questions

What is the standard ID for MADELINE SMITH (OD) in the U.S.?
In the U.S., MADELINE SMITH (OD) is identified by NPI 1205516143.
Does the public listing show MADELINE SMITH (OD) as active?
MADELINE SMITH (OD)'s NPI record reflects an active status in NPPES.
What type of care does MADELINE SMITH (OD) provide?
MADELINE SMITH (OD)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MADELINE SMITH (OD)?
MADELINE SMITH (OD) is associated with Wichita, Kansas in the same public data insurers reference.
Can I export MADELINE SMITH (OD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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