Michael Marty, OD
Individual provider Active NPI Optometrist · Murray, UT
NPI 1497743942 · NPPES record last updated Apr 22, 2008
Key facts
- NPI
- 1497743942
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2774349934 (UT)
- Practice address
- 6525 S State St
C/O Optical
Murray, UT 84107-7218 - Phone
- (801) 685-7989
- Fax
- (801) 685-9105
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6525 S State St
Murray, UT 84107-7218
Phone (801) 685-7989
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070216000224 | UT | Practitioner - Optometry | 5092817304 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2774349934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Standard Optical Co | Optometrist | Current |
Accepting new patients |
| Standard Optical Company | Optometrist | Current |
Accepting new patients |
| Ion Vision PLLC | Optometrist | Current |
Accepting new patients |
| Standard Optical Co | Optometrist | Current | Accepting new patients |
| Wasatch Eyeworks Inc | Optometrist | Current |
Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
| Standard Optical Co | Optometrist | Past | Accepting new patients |
Locations
140 W 5th S
Bountiful, UT 84010
Phone (801) 292-0479
4878 S Highland Dr
Holladay, UT 84117
Phone (801) 272-8861
1438 E Main St
Ste 4
Lehi, UT 84043
Phone (801) 753-7909
1153 N Main St
Ste A120
Logan, UT 84341
Phone (435) 752-2092
5289 S State St
Murray, UT 84107
Phone (801) 506-1111
4283 Harrison Blvd
Ste 8
Ogden, UT 84403
Phone (801) 479-5060
460 N 325 E
Ogden, UT 84404
Phone (801) 614-7239
4283 Harrison Blvd
Ogden, UT 84403
Phone (801) 479-5060
1455 S State St
Orem, UT 84097
Phone (801) 226-3044
1455 S State St
Ste A
Orem, UT 84097
1200 Towne Centre Blvd
Spc 1060
Provo, UT 84601
Phone (801) 373-2254
5421 S 1900 W
Roy, UT 84067
Phone (801) 825-9703
50 S Main St
Ste 115
Salt Lake City, UT 84101
Phone (801) 359-2260
6191 S State St
Ste 301
Salt Lake City, UT 84107
Phone (801) 268-0408
2124 S Highland Dr
Salt Lake City, UT 84106
Phone (801) 487-4138
6525 S State St
Salt Lake Cty, UT 84107
Phone (801) 685-7989
834 E 9400 S
Sandy, UT 84094
Phone (801) 553-9330
11514 S 4000 W
Ste 103
South Jordan, UT 84009
Phone (801) 214-0327
11278 S Jordan Gtwy
South Jordan, UT 84095
Phone (801) 545-9801
250 Red Cliffs Dr
St George, UT 84790
Phone (435) 674-2020
3754 W 5400 S
Taylorsville, UT 84129
Phone (801) 964-9911
966 N Main St
Tooele, UT 84074
Phone (435) 882-4815
1656 W 9000 S
West Jordan, UT 84088
Phone (801) 255-5454
1901 W Parkway Blvd
West Valley City, UT 84119
Phone (801) 886-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2774349934 | UT | Yes |
Addresses
Primary practice location
6525 S State St
C/O Optical
Murray, UT 84107-7218
Mailing address
13489 Corner Bridge LN
Draper, UT 84020-7803
Phone (801) 572-9789
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 999000797009 | Medicaid | UT | |
| 87017934007001 | Other | UT | BLUE CROSS/BLUE SHIELD |
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.