Bethany Ruth Gillett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

117805229934 Issued in UT

Practice address

3029 S Colt Plaza Dr Ste 1
West Valley City, UT 84128-4015

Phone

(801) 968-6772

Fax

(801) 968-6771

NPI assigned

May 27, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bethany Ruth Brown Former name

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Eyecare IncGroup PAC ID 3779515747, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• UT PPO
• UT PPO D-SNP

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.

• Mountain West Eyecare Inc

  • Optometrist
  • West Valley City, UT
  • NPI 1174708663
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1225651011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 S COLT PLAZA DR STE 1",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841284015",
            "telephone_number": "801-968-6772",
            "fax_number": "801-968-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3029 S COLT PLAZA DR STE 1",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841284015",
            "telephone_number": "801-968-6772",
            "fax_number": "801-968-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETT",
        "first_name": "BETHANY",
        "middle_name": "RUTH",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "117805229934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN WEST EYECARE, LLC",
            "identifier": "1174708663",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "BROWN",
            "middle_name": "RUTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Gerald H Geurts, PT
• Sariah Gist
• Glen E Johnson MD PC
• Terrell Glenn, MD
• Marissa Elaine Gochnour
• Rachel Gomez

• Optometrist in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.