BRADLEY GEORGE SMITH (OD) – Optometrist, NPI 1699769380

BRADLEY GEORGE SMITH (OD) is a healthcare provider. based in Tigard, Oregon. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. 1950ATI (OR). The NPI Number for BRADLEY GEORGE SMITH (OD) is 1699769380

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY GEORGE SMITH (OD)
NPI
1699769380
Phone
(503) 539-5115
Address
9169 SW BURNHAM ST
Enumeration Date
8 September 2005
Last Update Date
17 May 2010

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
5036395115
Graduation Year
1987 (39 years ago)
PAC ID
3173509486
Group Practice PAC ID
1355339300
Professional Enrollment ID
I20040629000013
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for BRADLEY GEORGE SMITH (OD)

  • 9169, Southwest Burnham Street, Downtown Tigard, Tigard, Washington County, Oregon, 97223, United States

    TIGARD, OR 972236105

    Phone: (503) 539-5115

    Fax: (503) 624-0542

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-06-29

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
I20040629000013IOptometryORTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97223)

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Reviews

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Frequently asked questions

Is BRADLEY GEORGE SMITH (OD) listed with a National Provider Identifier?
Yes — BRADLEY GEORGE SMITH (OD) has NPI 1699769380 on file in the registry.
Is BRADLEY GEORGE SMITH (OD) shown as active in public data?
Registry records indicate BRADLEY GEORGE SMITH (OD) maintains an active NPI.
What area of care is associated with BRADLEY GEORGE SMITH (OD)?
BRADLEY GEORGE SMITH (OD)'s record emphasizes Optometrist. Clinical services aligned with this taxonomy classification.
Is BRADLEY GEORGE SMITH (OD) located near Tigard?
BRADLEY GEORGE SMITH (OD) currently maps to Tigard, Oregon in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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