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DAVID THOMAS BROCKBANK MD
NPI 1093822561
Ophthalmology in Provo, UT

Active since August 23, 2006PECOS EnrolledAccepts Medicare Assignment
1055 N 500 W STE 201, PROVO, UT 84604(801) 375-6565(801) 373-9750 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About David Thomas Brockbank Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID THOMAS BROCKBANK MD (NPI 1093822561) is an individual ophthalmology provider in Provo, Utah, licensed in Utah (6540468-1205) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Albany Medical College Of Union University (2003).

NPPES Registry Identity

NPI1093822561
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDAVID THOMAS BROCKBANKCredential: MD
Location Address1055 N 500 W STE 201Provo, UT 84604-3305
Mailing Address1055 N 500 W, Attn: CredentialingProvo, UT 84604-3305 · (801) 354-8225 · Fax (801) 418-0941
Phone(801) 375-6565
Fax(801) 373-9750
Sole ProprietorNo
Medical School CMSAlbany Medical College Of Union UniversityGraduated 2003
Enumeration DateAugust 23, 2006
Last NPPES UpdateFebruary 25, 2026
NPPES CertifiedFebruary 25, 2026
✔ NPI 1093822561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in UT · 6540468-1205✔ Licensed in MO · T2003013455
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
1055 N 500 W STE 201, Provo, UT 84604
Open in Google Maps ↗

Secondary Practice Locations 2

Location 16065 Fashion Blvd, Ste 125Murray, UT 84107-7381 · Phone (801) 261-0726 · Fax (801) 262-2838
Location 25872 S 900 E Ste 100Murray, UT 84121-1677 · Phone (801) 261-0726 · Fax (801) 262-2838

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David Thomas Brockbank Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID345331443
PECOS Enrollment IDI20070803000153
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show David Brockbank reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Revere Health PC
5.9 mi
Multi-Specialty
1055 N 500 W
Provo, UT 84604
  • Reassigned Medicare billing, Utah enrollment
  • 414 clinicians in this Medicare group
NPI 1093764805 (801) 429-8000
Olympus Eye Associates, PC
28 mi
Ophthalmology
5872 S 900 E STE 100
Murray, UT 84121
  • Reassigned Medicare billing, Utah enrollment
  • 5 clinicians in this Medicare group
NPI 1912202425 (801) 261-0726

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for…
89%184 patients4/55-star benchmark: 100%
Age-Related Macular Degeneration (AMD): Dilated Macular Examination
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or…
99%184 patients4/55-star benchmark: 100%
Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance…
98%52 patients
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
100%22 patients5/55-star benchmark: 100%
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus…
40%42 patients2/55-star benchmark: 100%
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during…
88%42 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
86%2,349 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
94%613 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
77%1,555 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
1%185 patients1/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
0%378 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 37% · 349 patients
38%349 patients
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
100%121 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
56%1,555 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,555 patients1/55-star benchmark: 79%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 670 patients
0%670 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN L DONALDSON MD
Ophthalmology
1055 N 500 W STE 201
PROVO, UT 84604
Utah County (801) 375-6565
KRISTA M MARTINEZ FNP
Nurse Practitioner (Family)
1055 N 500 W STE 201
PROVO, UT 84604
Utah County (801) 429-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Brockbank's NPI number?

The NPI number for David Brockbank is 1093822561. It was assigned to this individual provider in the NPPES registry on August 23, 2006.

Where is David Brockbank located?

David Brockbank practices at 1055 N 500 W Ste 201, Provo, UT 84604. The listed phone number is (801) 375-6565.

What is David Brockbank's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is David Brockbank enrolled in Medicare?

Yes. David Brockbank is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for David Brockbank's services?

According to the CMS Revalidation Reassignment List (October 2026 release), David Brockbank reassigns Medicare benefits to 2 organizations: Revere Health PC (Provo, UT) and Olympus Eye Associates, PC (Murray, UT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for David Brockbank's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does David Brockbank accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health list David Brockbank as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for David Brockbank was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.