Mitchell Eli Pebley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

7378183-9934 Issued in UT

Practice address

1438 E Main St
#4
Lehi, UT 84043-3814

Phone

(801) 753-7999

Fax

(801) 753-7996

NPI assigned

Jun 23, 2009

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

Other identifiers 1

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Absolute VisionGroup PAC ID 1254518152, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Legacy Vision Group

  • Optometrist
  • West Haven, UT
  • NPI 1043509888
  Medicare reassignment Care Compare group NPD
• Legacy Vision Group Dba Elevation Eyeworks

  • Optometrist
  • West Haven, UT
  • NPI 1558944538
  NPD Authorized official
• Life Vision

  • Optometrist
  • Clearfield, UT
  • NPI 1093464588
  NPD
• Ogden Vision Center PLLC

  • Optometrist
  • Ogden, UT
  • NPI 1023220886
  NPD
• Standard Optical Co

  • Optometrist
  • Murray, UT
  • NPI 1508967977
  NPD (past)
• Standard Optical Co

  • Optometrist
  • Salt Lake City, UT
  • NPI 1962599290
  NPD (past)
• Standard Optical Company

  • Optometrist
  • West Point, UT
  • NPI 1659958841
  NPD (past)

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1710115332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 PARKWAY BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841192001",
            "telephone_number": "801-886-2020",
            "fax_number": "801-954-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 E MAIN ST",
            "address_2": "#4",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840433814",
            "telephone_number": "801-753-7999",
            "fax_number": "801-753-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEBLEY",
        "first_name": "MITCHELL",
        "middle_name": "ELI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "7378183-9934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023242435",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndi Anna Payne
• Zachary Payne
• Gary Pearson, OT
• Jared Kevin Pearson, M.D.
• Taya Pearson
• Sarah Makenzie Pedersen, BCBA, LBA
• Fidias A Penate II
• Madelin Taylor Pepper
• Perfect Pair ABA Ut LLC
• Anthony Steele Perry, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.
• 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.