Individual provider Active NPI

Jacob Lambertson, OD

  • Optometrist
  • Ogden, UT
National Provider Identifier
1083506042
Registry record updated Aug 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14233168-9934 Issued in UT
Practice address
3651 Wall Ave Ste 1226
Ogden, UT 84405-2007
Phone
(801) 901-3346
NPI assigned
Jul 16, 2025
Last updated
Aug 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 14233168-9934 UT Primary

Addresses

Primary practice location

3651 Wall Ave Ste 1226
Ogden, UT 84405-2007

Mailing address

2734 Brady Way
Layton, UT 84041-3423
Phone (612) 562-1714

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
I20250826003679 UT Practitioner - Optometry 1254831951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ion Vision PLLCGroup PAC ID 0042570426, 7 clinicians

Practice addresses (Care Compare)

3651 Wall Ave
Suite 1226
Ogden, UT 84405-2007
Phone (801) 901-3346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14233168-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ion Vision PLLC Optometrist CurrentSince Aug 11, 2025 Accepting new patients

Locations

3651 Wall Ave
Ste 1226
Ogden, UT 84405
Phone (801) 392-4358

50 S Main St
Ste 115
Salt Lake City, UT 84101
Phone (801) 359-2260

6191 S State St
Ste 301
Salt Lake City, UT 84107
Phone (801) 268-0408

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754697600000",
    "number": "1083506042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 BRADY WAY",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840413423",
            "telephone_number": "612-562-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 WALL AVE STE 1226",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844052007",
            "telephone_number": "801-901-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERTSON",
        "first_name": "JACOB",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-08-09",
        "certification_date": "2025-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "14233168-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.