NPIMap

Organization Active NPI

Central Utah Eye Associates

  • Ophthalmology Physician
  • Provo, UT
National Provider Identifier
1992722888
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CENTRAL UTAH EYE ASSOCIATES
Practice address
1735 N State St
Provo, UT 84604-1010
Phone
(801) 374-1818
Fax
(801) 379-2959
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Authorized official

Name
Mr. Dale Blake
Title
Administrator
Phone
(801) 374-1818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1735 N State St
Provo, UT 84604-1010

Mailing address

1735 N State St
Provo, UT 84604-1010
Phone (801) 374-1818

Other identifiers 1

IdentifierTypeStateIssuer
CB6367OtherUTRAIL ROAD MEDICARE

Other names 1

  • Excel Eye Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040117000232 UT Part B Supplier - Clinic/Group Practice 3577464908 Receives reassigned benefits from 18 practitioners
Practice locations: Orem, UT; Spanish Fork, UT; Saratoga Springs, UT; Richfield, UT; Provo, UT; Payson, UT; Nephi, UT; Lehi, UT…

National Provider Directory

National Provider Directory

Locations

360 E Main St
Ste 1
Delta, UT 84624
Phone (435) 864-3243

360 E Main St
Ste A1
Delta, UT 84624

220 N 1200 E
Ste 101
Lehi, UT 84043
Phone (801) 341-6200

696 W 800 N
Orem, UT 84057
Phone (801) 426-9800

120 E 200 N
Richfield, UT 84701
Phone (435) 896-2020

118 E Thrive Dr
Ste 210
Saratoga Springs, UT 84045
Phone (801) 379-2929

692 E Market Place Dr
Ste 101
Spanish Fork, UT 84660
Phone (801) 465-2575

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1992722888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818",
            "fax_number": "801-379-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 N STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041010",
            "telephone_number": "801-374-1818",
            "fax_number": "801-379-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL UTAH EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-374-1818",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CB6367",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Eye Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.