Individual provider Active NPI

Randy B Carter, O.D.

  • Optometrist
  • Salt Lake City, UT
National Provider Identifier
1174569990
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
112697-9934 Issued in UT
Practice address
755 E 3900 S
Salt Lake City, UT 84107-2105
Phone
(801) 266-2283
Fax
(801) 268-6151
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 112697-9934 UT Primary

Addresses

Primary practice location

755 E 3900 S
Salt Lake City, UT 84107-2105

Mailing address

755 E 3900 S
Salt Lake City, UT 84107-2105
Phone (801) 266-2283

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
I20100503000438 UT Practitioner - Optometry 4082780911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Institute of Utah IncGroup PAC ID 3678556438, 9 clinicians

Practice addresses (Care Compare)

755 E 3900
Salt Lake City, UT 84107-2105
Phone (801) 266-2283

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
98.84
Improvement activities
40
Cost
77.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112697-9934UTMDOptometrist
178WYMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute of Utah Inc CurrentSince Sep 10, 1986 Accepting new patients

Locations

755 E 3900 S
Salt Lake Cty, UT 84107
Phone (801) 266-2283

79 Winston Dr
Rock Springs, WY 82901
Phone (307) 705-2860

2631 Foothill Blvd
Ste A
Rock Springs, WY 82901
Phone (307) 362-4202

Networks

  • UT PPO
  • UT PPO D-SNP

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1174569990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072105",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072105",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "RANDY",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "112697-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.