Individual provider Active NPI

Kristin Ow Bretz, MD

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1578856431
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
9273536-1205 Issued in UT
Practice address
755 E 3900 S
Salt Lake City, UT 84107-2176
Phone
(801) 266-2283
Fax
(801) 268-6151
NPI assigned
May 25, 2011
Last updated
Feb 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 9273536-1205 UT Primary

Addresses

Primary practice location

755 E 3900 S
Salt Lake City, UT 84107-2176

Mailing address

755 E 3900 S
Salt Lake City, UT 84107-2176
Phone (801) 266-2283

Other identifiers 1

IdentifierTypeStateIssuer
1068983MedicaidUT

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702000764 UT Practitioner - OphthalmologyPractitioner - Optometry 9830401959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
New York University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Institute of Utah IncGroup PAC ID 3678556438, 9 clinicians

Practice addresses (Care Compare)

755 E 3900
Salt Lake City, UT 84107-2105
Phone (801) 266-2283

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
98.84
Improvement activities
40
Cost
77.15

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9273536-1205UTMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Institute of Utah Inc Ophthalmology CurrentSince Sep 1, 2018 Accepting new patients

Locations

755 E 3900 S
Salt Lake Cty, UT 84107
Phone (801) 266-2283

Interoperability endpoints

  • Direct secure messaging: kbretz@directaddress.net
  • Direct secure messaging: kchapman148561@direct.med.utah.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1578856431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072176",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072176",
            "telephone_number": "801-266-2283",
            "fax_number": "801-268-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETZ",
        "first_name": "KRISTIN",
        "middle_name": "OW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "9273536-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1068983",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.