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STACY R SMITH MD PC
NPI 1003162058
Ophthalmology in Salt Lake City, UT

Active since July 27, 2012
1548 E 4500 S, STE 105, SALT LAKE CITY, UT 84117(801) 424-3090(801) 424-3091 Get Directions Write a Review

NPPES record last updated: May 13, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Stacy R Smith Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY R SMITH MD PC (NPI 1003162058) is a healthcare organization registered as an ophthalmology in Salt Lake City, Utah and active in the NPI registry since July 2012. The organization lists Stacy R Smith, Physician, as its authorized official.

NPPES Registry Identity

NPI1003162058
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameSTACY R SMITH MD PC
Location Address1548 E 4500 S, STE 105Salt Lake City, UT 84117-4209
Mailing Address1548 E 4500 S, Ste 105Salt Lake City, UT 84117-4209 · (801) 424-3090 · Fax (801) 424-3091
Phone(801) 424-3090
Fax(801) 424-3091
Organization SubpartNo
Authorized OfficialStacy R SmithPhysician · (801) 424-3090
Enumeration DateJuly 27, 2012
Last NPPES UpdateMay 13, 2013
✔ NPI 1003162058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in UT · 60248791205
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1548 E 4500 S, Salt Lake City, UT 84117
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacy R Smith Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Stacy R Smith MD PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Stacy Smith, M.D.
Ophthalmology
NPI 1639348899
1548 E 4500 S STE 105
Salt Lake City, UT 84117
(801) 424-3090
✔ PECOS✔ Accepts MedicareSame address
Adam Bowman, MD
Ophthalmology
NPI 1184846131
1548 E 4500 S STE 105
Salt Lake City, UT 84117
(014) 243-0908
✔ PECOS✔ Accepts MedicareSame address
John Fassio, MD
Ophthalmology
NPI 1689671638
2700 HOMESTEAD RD
Park City, UT 84098
(435) 658-3090
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy R Smith MD PC's NPI number?

The NPI number for Stacy R Smith MD PC is 1003162058. It was assigned to this organization in the NPPES registry on July 27, 2012.

Where is Stacy R Smith MD PC located?

Stacy R Smith MD PC is located at 1548 E 4500 S Ste 105, Salt Lake City, UT 84117. The listed phone number is (801) 424-3090.

What is Stacy R Smith MD PC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stacy R Smith MD PC enrolled in Medicare?

Yes. Stacy R Smith MD PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Stacy R Smith MD PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Ophthalmology, reassign their Medicare billing to Stacy R Smith MD PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Stacy R Smith MD PC accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Stacy R Smith MD PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacy R Smith MD PC was last updated on May 13, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.