Jeremy Paul Gerritsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

70382989934 Issued in UT

Practice address

12391 S 4000 W
Riverton, UT 84096-7012

Phone

(801) 302-1700

Fax

(801) 302-1714

NPI assigned

Jun 25, 2008

Sex

Male

Sole proprietor

No

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vision Health Center, Inc.

  • Optometrist
  • West Jordan, UT
  • NPI 1558487975
  Medicare reassignment
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  NPD (past)

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1538321237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700",
            "fax_number": "801-302-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700",
            "fax_number": "801-302-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRITSEN",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "70382989934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron J Geary
• Peter Joseph Gencarelli, MAP, BCBA
• Kylie Genetti
• Laura Rebecca Gengler, CSW
• Aubrey Rochelle George, FNP-C
• Mindy Gerritsen
• Claudia Giannelli
• Leslie J. Gibb, MS, LMHC
• Kevin Gilbert, M.D.
• Mykayla Giles

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.