Nathan Cody Mortensen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

100403 Issued in ID

Practice address

49 E 1St S
Rexburg, ID 83440-1966

Phone

(208) 356-4444

NPI assigned

May 26, 2017

Last updated

May 26, 2017By the provider in NPPES

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 ID

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

Southern California College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rexburg Vision CenterGroup PAC ID 1153475124, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nathan.mortensen@direct.revolutionehr.com

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.

• Rexburg Vision Center

  • Optometrist
  • Rexburg, ID
  • NPI 1801830666
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495756800000",
    "number": "1194253682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 FAIRVIEW AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405078",
            "telephone_number": "208-351-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "NATHAN",
        "middle_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-26",
        "last_updated": "2017-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "100403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey J Morey
• James Morris, MD
• Susan Olivia Morris, LMSW
• Damon Scott Mortensen, OD
• H. Scott Mortensen III, OD
• Stephen Gary Moss, PHARM.D.
• Mountain Health and Wellness
• Mountain Valley Imaging LLC
• Mountain View Hospital LLC
• Mountain View Hospital LLC (Community Care Rexburg)

• Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.