Individual provider Active NPI

Renee A McIntosh, O.D.

  • Optometrist
  • Draper, UT
National Provider Identifier
1003057894
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
47865699934 Issued in UT
Practice address
11820 S State St
Ste. 200
Draper, UT 84020-7133
Phone
(801) 568-0200
Fax
(801) 563-0200
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 47865699934 UT Primary

Addresses

Primary practice location

11820 S State St
Ste. 200
Draper, UT 84020-7133

Mailing address

11820 S State St
Ste. 200
Draper, UT 84020-7133
Phone (801) 568-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000316 UT Practitioner - Optometry 0648291617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoopes Vision Correction Center PCGroup PAC ID 7618874231, 11 clinicians

Practice addresses (Care Compare)

11820 S State St
Suite 200
Draper, UT 84020-7160
Phone (801) 568-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47865699934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopes Vision Correction Center, PC CurrentSince Jan 2, 2011 Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients

Locations

11820 S State St
Ste 200
Draper, UT 84020
Phone (801) 568-0200

Interoperability endpoints

  • Direct secure messaging: rmcintosh@hoopes.intellechartdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1003057894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 S STATE ST",
            "address_2": "STE. 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207133",
            "telephone_number": "801-568-0200",
            "fax_number": "801-563-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 S STATE ST",
            "address_2": "STE. 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207133",
            "telephone_number": "801-568-0200",
            "fax_number": "801-563-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "RENEE",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "47865699934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.