Damon Scott Mortensen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100185 Issued in ID

Practice address

49 E 1St S
Rexburg, ID 83440-1966

Phone

(208) 356-4444

Fax

(208) 356-4445

NPI assigned

Jun 22, 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

Medicare fee-for-service enrollment

Enrolled in ID

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

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rexburg Vision CenterGroup PAC ID 1153475124, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: damon@rexburgvision.eyeclinicdirect.net

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.

• Rexburg Vision Center

  • Optometrist
  • Rexburg, ID
  • NPI 1801830666
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1760619365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 E 1ST S",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401966",
            "telephone_number": "208-356-4444",
            "fax_number": "208-356-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "DAMON",
        "middle_name": "SCOTT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Herchell Moore, NP
• Hannah Mora
• Lindsey J Morey
• James Morris, MD
• Susan Olivia Morris, LMSW
• H. Scott Mortensen III, OD
• Nathan Cody Mortensen, OD
• Stephen Gary Moss, PHARM.D.
• Mountain Health & Wellness
• Mountain Valley Imaging LLC

• Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.