Ryan J Mortensen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5898711-9934 Issued in UT

Practice address

11506 S District Dr
Ste 400
South Jordan, UT 84095-5769

Phone

(801) 495-4833

Fax

(801) 495-4836

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

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.

• Ryan J. Mortensen, Inc

  dba District Vision Care

  • Optometrist
  • South Jordan, UT
  • NPI 1932566726
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1003818576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11506 S DISTRICT DR",
            "address_2": "STE 400",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955769",
            "telephone_number": "801-495-4833",
            "fax_number": "801-495-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11506 S DISTRICT DR",
            "address_2": "STE 400",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955769",
            "telephone_number": "801-495-4833",
            "fax_number": "801-495-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "RYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5898711-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caio Moraes Rego
• Deborah Elizabeth Morgan, DNP, APRN, PMHNP-BC
• Makenna Aleece Morgan, LCSW
• Pamela Morrison, RDN, CSO
• Kumiko Isomichi Morse, ACMHC
• Taylor Mortensen
• Jared Moser, DPT
• Lyn Mouhaffel, DMD
• Mountain Pointe Physical Therapy, PC
• Mountain Valley Counseling, LLC

• Optometrist in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.