Craig A Pew, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

77134459934 Issued in UT

Practice address

200 N Market Place Dr
Centerville, UT 84014-1752

Phone

(801) 295-7118

NPI assigned

Jan 21, 2011

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 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

Illinois College of Optometry at Chicago, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kickapoo Management LLCGroup PAC ID 2264743210, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Kickapoo Management LLC

  • Eyewear Supplier
  • Perry, UT
  • NPI 1568849073
  Medicare reassignment Care Compare group NPD
• Dr Larsen Eye Care Inc

  • Optometrist
  • Layton, UT
  • NPI 1215110929
  Medicare reassignment NPD

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396569600000",
    "number": "1821393810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E 1250 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840412438",
            "telephone_number": "706-575-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N MARKET PLACE DR",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840141752",
            "telephone_number": "801-295-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEW",
        "first_name": "CRAIG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2014-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "77134459934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul M Huffaker, DMD, PLLC
• Karina C Penrod, LCSW
• John D. Perovich, PSY.D.
• Chelsea Petersen
• Robert Peterson
• Marian H Pham, MD
• Brandon Jay Phelps
• Pitt Family Dental
• Bruce G Pitt, DMD
• Jason Pitt, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.