Active NPI
Michael Mark Monson, O.D.
- Optometrist
- Heber City, UT
National Provider Identifier
1205927175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12983357-9934
- Practice address
- 345 W 600 S Ste 300
Heber City, UT 84032-2268 - Phone
- (435) 654-1863
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 757 OPT | MT | |
| Optometrist | 152W00000X | 12983357-9934 | UT | Primary |
Addresses
Primary practice location
345 W 600 S Ste 300
Heber City, UT 84032-2268
Mailing address
30 S 1970 E
Heber City, UT 84032-4420
Phone (406) 565-8298
Other practice location 1
6584 Creekside Dr
Park City, UT 84098-5791
Phone (435) 649-5200
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0483072 | Medicaid | MT | |
| 28091 | Other | MT | BLUE CROSS BLUE SHIELD MT |
| DB9976 | Other | MT | RR MCR GROUP # (ODPC) |
| 121304100 | Medicaid | WY | |
| OD 075 MT | Medicaid | AK |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
345 W 600
Suite 300
Heber City, UT 84032-2268
Phone (435) 654-1863
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 757 OPT | MT | MD | Optometrist |
| 12983357-9934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Cory B. Seitz O.D.,P.C. | Optometrist | Current | Accepting new patients |
Locations
345 W 600 S
Ste 300
Heber City, UT 84032
Phone (435) 654-1863
Networks
- UT PPO D-SNP
- UT PPO
Organizations & group practices 2
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.
-
- Optometrist
- Heber City, UT
- NPI 1417562612
-
- Optometrist
- West Jordan, UT
- NPI 1558487975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1205927175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 S 1970 E",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840324420",
"telephone_number": "406-565-8298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 W 600 S STE 300",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840322268",
"telephone_number": "435-654-1863"
}
],
"practiceLocations": [
{
"address_1": "6584 Creekside Dr",
"address_purpose": "LOCATION",
"city": "Park City",
"state": "UT",
"postal_code": "840985791",
"country_code": "US",
"telephone_number": "435-649-5200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONSON",
"first_name": "MICHAEL",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MT",
"license": "757 OPT",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "12983357-9934",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0483072",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MT",
"identifier": "28091",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR GROUP # (ODPC)",
"identifier": "DB9976",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121304100",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OD 075 MT",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Heber City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.