South Valley Optical is a medicare enrolled "Eyewear Supplier" provider in Draper, Utah. Their current practice location is
261 W. Data Dr., Draper, Utah. You can reach out to their office (for appointments etc.) via phone at
(801) 316-5508.
South Valley Optical is licensed to practice in Utah (license number 1394746-0143) and it also participates in the medicare program. South Valley Optical
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1225373640.
Healthcare Provider's Profile
| Full Name | South Valley Optical |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 261 W. Data Dr., Draper, Utah |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1225373640
- Provider Enumeration Date: 12/11/2012
- Last Update Date: 07/15/2015
Medicare PECOS Information:
- PECOS PAC ID: 2365742988
- Enrollment ID: O20151203000210
Medical Identifiers
Medical identifiers for South Valley Optical such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225373640 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 5343369-9934 (Utah) | Secondary |
| 152WC0802X | Optometrist - Corneal And Contact Management | 5343369-9934 (Utah) | Secondary |
| 152WL0500X | Optometrist - Low Vision Rehabilitation | 5343369-9934 (Utah) | Secondary |
| 152WP0200X | Optometrist - Pediatrics | 5343369-9934 (Utah) | Secondary |
| 152WS0006X | Optometrist - Sports Vision | 5343369-9934 (Utah) | Secondary |
| 152WV0400X | Optometrist - Vision Therapy | 5343369-9934 (Utah) | Secondary |
| 152WX0102X | Optometrist - Occupational Vision | 5343369-9934 (Utah) | Secondary |
| 156FC0800X | Technician/technologist - Contact Lens | (* (Not Available)) | Secondary |
| 156FC0801X | Technician/technologist - Contact Lens Fitter | (* (Not Available)) | Secondary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | 1394746-0143 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
South Valley Optical acts as a billing entity for following providers:
| Provider Name | Bruce T Childs |
|---|
| Provider Type | Practitioner - Optometry |
|---|
| Provider Identifiers | NPI Number: 1235194838
PECOS PAC ID: 5799779054
Enrollment ID: I20040412000359 |
|---|
| Provider Name | Sheri E Meyer |
|---|
| Provider Type | Practitioner - Optometry |
|---|
| Provider Identifiers | NPI Number: 1942439500
PECOS PAC ID: 1153477062
Enrollment ID: I20090917000671 |
|---|
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. South Valley Optical 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 |
|---|
South Valley Optical
261 W. Data Dr.,
Draper, UT 84020-7942
Ph: (801) 316-5508 | South Valley Optical
261 W. Data Dr.,
Draper, UT 84020-7942
Ph: (801) 316-5508 |
Reviews and Comments