Jacob Michael Robison, O.D.
Individual provider Active NPI Optometrist · Ephraim, UT
NPI 1780970582 · NPPES record last updated Jun 21, 2011
Key facts
- NPI
- 1780970582
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8015719-9934 (UT)
- Practice address
- 43 E 450 N
Ephraim, UT 84627-4027 - Phone
- (435) 283-5555
- NPI assigned
- Jun 21, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eye Center of Ephraim LLC
Practice addresses (Care Compare)
43 E 450
Ephraim, UT 84627-4027
Phone (435) 283-5555
Hospital & facility affiliations
- Intermountain Health Sanpete Valley Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 36 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110713000488 | UT | Practitioner - Optometry | 6608044888 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8015719-8908 | UT | MD | Optometrist |
| 8015719-9934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Center of Ephraim, LLC | Optometrist | Current |
Accepting new patients |
| Rocky Mountain University of Health Professions Foundation | Optometrist | Current |
Accepting new patients |
Locations
43 E 450 N
Ephraim, UT 84627
Phone (435) 283-5555
122 E 1700 S
Bldg 3
Provo, UT 84606
Phone (385) 248-5550
Interoperability endpoints
- jacob.robison@uprisedirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8015719-9934 | UT | Yes |
| Optometrist | 152W00000X | 8015719-8908 | UT |
Addresses
Primary practice location
43 E 450 N
Ephraim, UT 84627-4027
Mailing address
43 E 450 N
Ephraim, UT 84627-4027
Phone (435) 283-5555
Other providers in Ephraim, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.