NPIMap

Organization Active NPI

Mt Ogden Eye Center LLC

Doing business as Utah Eye Centers

  • Ophthalmology Physician
  • Ogden, UT
National Provider Identifier
1700927043
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MT OGDEN EYE CENTER LLC
Doing business as
Utah Eye Centers
Practice address
4360 Washington Blvd
Ogden, UT 84403-1866
Phone
(801) 476-0494
Fax
(801) 476-0067
NPI assigned
Feb 9, 2007
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Sarah Howell
Title
Credentialing Manager
Phone
(801) 409-9900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

4360 Washington Blvd
Ogden, UT 84403-1866

Mailing address

4360 Washington Blvd
Ogden, UT 84403-1866
Phone (801) 476-0494

Other names 1

  • UTAH EYE CENTERS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040602001630 UT Part B Supplier - Clinic/Group Practice 2860474962 Receives reassigned benefits from 21 practitioners
2 other NPIs on this enrollment
Practice locations: Salt Lake City, UT; Tooele, UT; Tremonton, UT; Vernal, UT; Pleasant Grove, UT; Price, UT; Roosevelt, UT; Ogden, UT…
O20100930054045 UT DME Supplier - Physician - OphthalmologyDME Supplier - Physician - OptometristDME Supplier - Optician 2860474962 Practice locations: Ogden, UT
O20190304001332 WY Part B Supplier - Clinic/Group Practice 2860474962 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, WY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D1092216Utah Eye Centers4360 Washington Blvd, Ogden, UT 84403Certificate of waiverNov 19, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Utah Eye Centers4360 Washington Blvd, Ogden, UT 84403-1866(801) 476-0494 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Nov 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Mt Ogden Eye Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

69 E Main St
Price, UT 84501
Phone (435) 637-2000

165 W 200 N
Ste 717
Roosevelt, UT 84066

201 E 5900 S
Ste 201
Salt Lake Cty, UT 84107
Phone (801) 268-6408

465 W 600 N
Tremonton, UT 84337

Interoperability endpoints

  • Direct secure messaging: calldredge@utaheyecenters.intellechartdirect.net
  • Direct secure messaging: jarmstrong@utaheyecenters.intellechartdirect.net
  • Direct secure messaging: mballif@utaheyecenters.intellechartdirect.net
  • Direct secure messaging: mbullard@utaheyecenters.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1700927043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-476-0494",
            "fax_number": "801-476-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-476-0494",
            "fax_number": "801-476-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT OGDEN EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "HOWELL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "801-409-9900"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTAH EYE CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.