Frank A Siddoway, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

112569-9934 Issued in UT

Practice address

1675 N 200 W
#11- A
Provo, UT 84604-2540

Phone

(801) 374-2227

Fax

(801) 374-5197

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• CLR Vision PC

  • Optometrist
  • Provo, UT
  • NPI 1235304064
  Medicare reassignment NPD
• CLR Vision PC

  • Optometrist
  • Springville, UT
  • NPI 1396926002
  NPD
• Utah Valley Optometric Physicians

  • Optometrist
  • Springville, UT
  • NPI 1760545735
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1255343695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 N 200 W",
            "address_2": "#11- A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-374-2227",
            "fax_number": "801-374-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N 200 W",
            "address_2": "#11- A",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-374-2227",
            "fax_number": "801-374-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDOWAY",
        "first_name": "FRANK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "112569-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Ann Shupe, SUDC
• Christina Diane Shurtz, SSW
• Si Procedure Center
• Katelyn Siano
• Sean Michael Sibbett, PT
• Rebecca Kaimilani Siddoway
• Ryan Lorenzo Sights, PSS, SUDC
• Jaden Sigua
• Alejandro Siles, DMD
• Hayley Suzanne Sillitoe

• Optometrist in Provo, UT
• Providers in Provo, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.