Individual provider Active NPI

Robert Lynn Simmons, O.D.

  • Optometrist
  • American Fork, UT
National Provider Identifier
1689633877
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
114653-9934 Issued in UT
Practice address
12 N 1100 E
American Fork, UT 84003-2952
Phone
(801) 756-9627
Fax
(801) 763-0126
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 114653-9934 UT Primary

Addresses

Primary practice location

12 N 1100 E
American Fork, UT 84003-2952

Mailing address

12 N 1100 E
American Fork, UT 84003-2952
Phone (801) 756-9627

Other identifiers 5

IdentifierTypeStateIssuer
1689633877MedicaidUT
164679OtherUTDMBA
275926OtherUTALTIUS
87688OtherUTPEHP
87028357684003A004OtherUTTRICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000044 UT Practitioner - Optometry 0648280263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Utah Eye AssociatesGroup PAC ID 3577464908, 17 clinicians

Practice addresses (Care Compare)

12 N 1100
American Fork, UT 84003-2952
Phone (801) 756-9627

Merit-based Incentive Payment System (MIPS)

Final score
86.79 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Eye Associates CurrentSince Nov 4, 2002 Accepting new patients
Hurricane Valley Eye Care PC Optometrist PastSince Oct 25, 2017 Accepting new patients
Southern Utah Eye Care Inc Optometrist PastSince Jun 19, 2015 Accepting new patients

Locations

12 N 1100 E
American Fork, UT 84003
Phone (801) 756-9627

1735 N State St
Provo, UT 84604
Phone (801) 374-1818

118 E Thrive Dr
Ste 210
Saratoga Springs, UT 84045
Phone (801) 379-2929

Interoperability endpoints

  • Direct secure messaging: robert.simmons.p1@direct.exceleyecenter.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1689633877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032952",
            "telephone_number": "801-756-9627",
            "fax_number": "801-763-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032952",
            "telephone_number": "801-756-9627",
            "fax_number": "801-763-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ROBERT",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "114653-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689633877",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "164679",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "275926",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "87688",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "87028357684003A004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.