Brock C Hansen, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

11197395-1205 Issued in UT

Practice address

4360 Washington Blvd
Ogden, UT 84403-1866

Phone

(801) 476-0494

Fax

(801) 479-3937

NPI assigned

Apr 2, 2014

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

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Texas Southwestern Medical School at Dallas, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mt Ogden Eye Center LLCGroup PAC ID 2860474962, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bear River Valley Hospital Hospital, Tremonton, UT, CCN 460039

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drhansen@utaheye.imwdirect.com

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.

• Mt Ogden Eye Center LLC

  • Ophthalmology Physician
  • Ogden, UT
  • NPI 1700927043
  Medicare reassignment Care Compare group NPD
• Mt Ogden Eye Center LLC

  • Ophthalmology Physician
  • Bountiful, UT
  • NPI 1740431428
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • General Acute Care Hospital
  • Tremonton, UT
  • NPI 1679582944
  Care Compare affiliation

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1992123376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015",
            "address_2": "DPT 93",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300015",
            "telephone_number": "801-476-0494",
            "fax_number": "801-479-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844031866",
            "telephone_number": "801-476-0494",
            "fax_number": "801-479-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 E 3300 S Ste B",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841064389",
            "country_code": "US",
            "telephone_number": "801-476-0494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "214 W 1500 S Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bountiful",
            "state": "UT",
            "postal_code": "840107408",
            "country_code": "US",
            "telephone_number": "801-476-0494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "BROCK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-02",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "UT",
            "license": "11197395-1205",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "11197395-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony B Hanebrink, LMFT
• Andrew Michael Hanley, LCSW
• Melissa Camille Hanni-Smith, DNP, APRN, FNP-C
• Carrie Hanni
• Amberly Jill Hansen, SUDC-I
• Chase Collingford Hansen, M.D.
• Craig L Hansen, MD
• Heather Hansen
• Jennifer Hansen
• Joshua Clifford Hansen, MD

• Ophthalmology Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.