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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ROY RAYMOND GIBSON O.D.
NPI 1104816743
Optometrist in Riverdale, UT

Active since October 25, 2005PECOS Enrolled
4949 S 900 W, RIVERDALE, UT 84405(801) 621-0480(801) 612-3485 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Roy Raymond Gibson O.d. NPPES

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

ROY RAYMOND GIBSON O.D. (NPI 1104816743) is an individual optometrist in Riverdale, Utah, licensed in Utah (1130289934) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Houston - College Of Optometry (1985).

NPPES Registry Identity

NPI1104816743
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameROY RAYMOND GIBSONCredential: O.D.
Location Address4949 S 900 WRiverdale, UT 84405-3777
Mailing Address5690 S 3750 WRoy, UT 84067-8161 · (801) 985-4141 · Fax (801) 985-4242
Phone(801) 621-0480
Fax(801) 612-3485
Sole ProprietorNo
Medical School CMSUniversity Of Houston - College Of OptometryGraduated 1985
Enumeration DateOctober 25, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1104816743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in UT · 1130289934✔ Licensed in UT · 1130288904
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
4949 S 900 W, Riverdale, UT 84405
Open in Google Maps ↗

Other Identifiers 4

Other1737499UT · First Health Network
Other589803UT · Dmba
Other11445324UT · Caqh
Other81820UT · Pehp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roy Raymond Gibson O.d. 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 ID5294725834
PECOS Enrollment IDI20040514001008
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services35 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84405 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.

Other Providers at the Same Location NPPES 3

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

SAMS WEST INC
Pharmacy (Community/Retail Pharmacy)
4949 S 900 W
RIVERDALE, UT 84405
Weber County (801) 612-3477
SAM'S CLUB OPTICAL
Eyewear Supplier
4949 S 900 W
RIVERDALE, UT 84405
Weber County (801) 612-3465
MRS. ANDREA CHRISTINE GUNNERSON RPH
Pharmacist
4949 S 900 W
RIVERDALE, UT 84405
Weber County (801) 612-3477

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 Roy Gibson's NPI number?

The NPI number for Roy Gibson is 1104816743. It was assigned to this individual provider in the NPPES registry on October 25, 2005.

Where is Roy Gibson located?

Roy Gibson practices at 4949 S 900 W, Riverdale, UT 84405. The listed phone number is (801) 621-0480.

What is Roy Gibson's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Roy Gibson enrolled in Medicare?

Yes. Roy Gibson 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.

What insurance does Roy Gibson accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 2 other insurers list Roy Gibson 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 Roy Gibson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days 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.