Individual provider Active NPI

Ronald M Pugh, OD

  • Optometrist
  • Spanish Fork, UT
National Provider Identifier
1013012715
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
302 Issued in UT
Practice address
846 Expressway Lane Spanish Fork, Ut
Spanish Fork, UT 84660-1330
Phone
(801) 798-2020
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 302 UT Primary

Addresses

Primary practice location

846 Expressway Lane Spanish Fork, Ut
Spanish Fork, UT 84660-1330

Mailing address

321 W Center St
Spanish Fork, UT 84660-2024
Phone (801) 798-7496

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
I20080227000254 UT Practitioner - Optometry 9335223544 Reassigns benefits to 2 organizations
Practice locations: Spanish Fork, UT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Pros Spanish Fork LLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Eye Pros of Logan LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Keeneye Family Vision PC Optometrist Past Accepting new patients

Locations

3485 N Cole Rd
Unit 45479
Boise, ID 83711

1475 N Main St
Ste 103
Logan, UT 84341
Phone (208) 297-7019

846 Expressway Ln
Spanish Fork, UT 84660
Phone (385) 337-4688

Networks

  • UT PPO
  • UT PPO D-SNP

Organizations & group practices 3

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1013012715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W CENTER ST",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846602024",
            "telephone_number": "801-798-7496",
            "fax_number": "801-373-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 EXPRESSWAY LANE SPANISH FORK, UT",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601330",
            "telephone_number": "801-798-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "RONALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

Verify at the official NPI Registry.