Peter Lloyd Kolbay, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

109787-9934 Issued in UT

Practice address

6191 S State St
Sears Optical Fashion Place Mall
Murray, UT 84107-7258

Phone

(801) 281-4281

NPI assigned

Dec 18, 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

Specialty

Optometry

Education

New England College of Optometry, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ion Vision PLLCGroup PAC ID 0042570426, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ion Vision PLLC

  • Optometrist
  • Murray, UT
  • NPI 1376099432
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457414666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 SOMMET DR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841176353",
            "telephone_number": "801-273-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6191 S STATE ST",
            "address_2": "SEARS OPTICAL FASHION PLACE MALL",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077258",
            "telephone_number": "801-281-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBAY",
        "first_name": "PETER",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "109787-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danette Ko, MD
• Emilie Kobler, CSW
• Kayla Koenig, OTR/L
• Cory Kogelschatz
• James Michael Kohler, MD
• Makenzie Kolbo
• Kimberlee Koller
• Selma Subin Koo
• Jessica Marie Koontz, PT, DPT
• Ines Katharina Korbanka, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.