David Thomas Brockbank, MD in Provo, UT

David Thomas Brockbank, MD is a medicare enrolled "Ophthalmology" physician in Provo, Utah. His current practice location is 1055 N 500 W Ste 201, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 375-6565.

David Thomas Brockbank is licensed to practice in Utah (license number 6540468-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093822561.

Contact Information

	David Thomas Brockbank, MD
	1055 N 500 W Ste 201, Provo, UT 84604-3305
	(801) 375-6565
	(801) 373-9750

Map and Direction

Physician's Profile

Full Name	David Thomas Brockbank
Gender	Male
Speciality	Ophthalmology
Location	1055 N 500 W Ste 201, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093822561
Provider Enumeration Date: 08/23/2006
Last Update Date: 02/25/2026

Medicare PECOS Information:

PECOS PAC ID: 0345331443
Enrollment ID: I20070803000153

Medical Identifiers

Medical identifiers for David Thomas Brockbank such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093822561	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207W00000X	Ophthalmology	6540468-1205 (Utah)	Primary
207W00000X	Ophthalmology	T2003013455 (Missouri)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. David Thomas Brockbank allows following entities to bill medicare on his behalf.

Entity Name	Central Utah Clinic Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805

Entity Name	Olympus Eye Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1912202425 PECOS PAC ID: 9739360181 Enrollment ID: O20110218000309

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. David Thomas Brockbank is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
David Thomas Brockbank, MD 1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225	David Thomas Brockbank, MD 1055 N 500 W Ste 201, Provo, UT 84604-3305 Ph: (801) 375-6565

Reviews and Comments

Ophthalmology Doctors in Provo, UT

Jonathan B Gunther, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1735 N State St, Provo, UT 84604 Phone: 801-379-2904 Fax: 801-379-2959
Thomas Dyreng Myers, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 280 River Park Dr, Suite 220, Provo, UT 84604 Phone: 801-224-3565 Fax: 801-224-3567
Dr. Matthew Reed Parsons, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1735 N State St, Provo, UT 84604 Phone: 801-374-1818 Fax: 801-379-2959
Dr. James G Theurer, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1735 N State St, Provo, UT 84604 Phone: 801-374-1818 Fax: 801-379-2959
Norman Kent Linton, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1735 N State St, Provo, UT 84604 Phone: 801-374-1818 Fax: 801-374-0163
Dr. Michael J Lloyd, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 300 W Ste 204, Provo, UT 84604 Phone: 801-357-7373 Fax: 801-357-7217

David Thomas Brockbank, MD - Medicare Ophthalmology in Provo, UT