NPIMap

Organization Active NPI

Central Utah Optical

Doing business as Excel Eye Center

  • Eyewear Supplier
  • Provo, UT
National Provider Identifier
1396831483
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
CENTRAL UTAH OPTICAL
Doing business as
Excel Eye Center
Practice address
1735 N State St
Provo, UT 84604-1010
Phone
(801) 374-1818
Fax
(801) 379-2959
NPI assigned
Oct 5, 2006
Last updated
Mar 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Authorized official

Name
Mr. Ron Dunn
Title
Administrator
Phone
(801) 374-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1735 N State St
Provo, UT 84604-1010

Mailing address

1735 North State Street
Provo, UT 84604-1010
Phone (801) 374-1818

Other identifiers 1

IdentifierTypeStateIssuer
1284570001OtherUTCIGNA DMERC

Other names 1

  • Excel Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930066449 UT DME Supplier - Physician - OptometristDME Supplier - Optician 3577684836 Practice locations: Provo, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Excel Optical1735 N State St, Provo, UT 84604-1010(801) 374-1818 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Does not accept assignmentParticipating since Sep 27, 1999

National Provider Directory

National Provider Directory
Tax ID family
Central Utah Optical6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1396831483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 NORTH STATE STREET",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818",
            "fax_number": "801-379-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818",
            "fax_number": "801-379-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL UTAH OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-374-1818",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DMERC",
            "identifier": "1284570001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.