Jeffrey L Cromwell, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

62492069934 Issued in UT

Practice address

1300 N 200 E
Suite 104
Logan, UT 84341-2398

Phone

(435) 752-6453

Fax

(435) 752-6486

NPI assigned

Aug 21, 2006

Last updated

Mar 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT, ID2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care for You LLCGroup PAC ID 1951466481, shared by 2 NPIs, 3 clinicians

Aeg Utah Professional IncGroup PAC ID 2062918618, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aeg Utah Professional Inc

  • Optometrist
  • Logan, UT
  • NPI 1154212777
  Medicare reassignment Care Compare group NPD
• Eyecare Specialties of Idaho PC

  • Optometrist
  • Preston, ID
  • NPI 1417848037
  Medicare reassignment NPD
• Eye Care for You LLC

  • Optometrist
  • Logan, UT
  • NPI 1619112398
  Medicare reassignment
• Eye Care for You LLC

  • Optometrist
  • Preston, ID
  • NPI 1548405327
  Medicare reassignment
• Eye Care for You

  • Optometrist
  • Sandpoint, ID
  • NPI 1710042353
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1801902333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SUMMIT DR",
            "city": "SMITHFIELD",
            "state": "UT",
            "postal_code": "843351143",
            "telephone_number": "435-563-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 200 E",
            "address_2": "SUITE 104",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412398",
            "telephone_number": "435-752-6453",
            "fax_number": "435-752-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMWELL",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "62492069934",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100129",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801902333",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801902333",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1594509",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000055942",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David T Cragun, MD
• Andrea Rachel Craig, FNP
• Brian G Crandall, M.D.
• F. Michael Crane, M.D
• Keaton Crockett, PHARMD
• Ranee Oteiko Cronquist, LCSW
• Daniel Blackmore Crook
• Amanda Crosland
• Susan Crowley, P.H.D.
• Rachel Ann Crummitt, SSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.