Individual provider Active NPI

Adam L Lewis, DO

  • Ophthalmology Physician
  • Pleasant Grove, UT
National Provider Identifier
1720737679
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
14284164-1204 Issued in UT
Practice address
1972 W Grove Pkwy Ste 300
Pleasant Grove, UT 84062-6729
Phone
(801) 476-0494
Fax
(801) 221-1052
NPI assigned
Mar 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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 14284164-1204 UT Primary

Addresses

Primary practice location

1972 W Grove Pkwy Ste 300
Pleasant Grove, UT 84062-6729

Mailing address

1972 W Grove Pkwy Ste 300
Pleasant Grove, UT 84062-6729
Phone (801) 224-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220720001515 MO Order and Referring Only - OphthalmologyPractitioner - Internal MedicinePractitioner - Ophthalmology 9133500275

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Kansas City University of Physicians and Surgeons, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4360 Washington Blvd
Ogden, UT 84403-1866

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000-00UTMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1720737679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 W GROVE PKWY STE 300",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840626729",
            "telephone_number": "801-224-6767",
            "fax_number": "801-221-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 W GROVE PKWY STE 300",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840626729",
            "telephone_number": "801-476-0494",
            "fax_number": "801-221-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ADAM",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-19",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "14284164-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.