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SALT LAKE RETINA
NPI 1144622234
Ophthalmology - Retina Specialist in West Jordan, UT

Active since September 19, 2014CLIA Certified · 3 labs
3855 W 7800 S, SUITE 100, WEST JORDAN, UT 84088(801) 260-0034(801) 260-0035 Get Directions Write a Review

NPPES record last updated: April 10, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Salt Lake Retina NPPES

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

SALT LAKE RETINA (NPI 1144622234) is a healthcare organization registered as a retina specialist in West Jordan, Utah and active in the NPI registry since September 2014. The organization holds 3 active CLIA laboratory certificates and lists Douglas S Mehr, President, as its authorized official.

NPPES Registry Identity

NPI1144622234
Entity TypeOrganization
Primary Taxonomy207WX0107X
Legal Business NameSALT LAKE RETINA, LLC
Location Address3855 W 7800 S, SUITE 100West Jordan, UT 84088-5560
Mailing Address3855 W 7800 S, Suite 100West Jordan, UT 84088-5560 · (801) 260-0034 · Fax (801) 260-0035
Phone(801) 260-0034
Fax(801) 260-0035
Organization SubpartNo
Authorized OfficialDouglas S MehrPresident · (801) 260-0034
Enumeration DateSeptember 19, 2014
Last NPPES UpdateApril 10, 2023
NPPES CertifiedSeptember 8, 2022
✔ NPI 1144622234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 5934492-1205 (UT)
3855 W 7800 S, West Jordan, UT 84088
Open in Google Maps ↗

Other Names 1

Doing Business AsSalt Lake Retina

Other Identifiers 1

Medicaid1508052234UT

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Salt Lake Retina is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Salt Lake Retina, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Andrew Davis, M.D.
Ophthalmology
NPI 1922012582
3855 W 7800 S STE 100
West Jordan, UT 84088
(801) 260-0034
✔ PECOS✔ Accepts MedicareSame address
Christopher Gee, M.D.
Ophthalmology
NPI 1831372499
3855 W 7800 S STE 100
West Jordan, UT 84088
(801) 260-0034
✔ PECOS✔ Accepts MedicareSame address
Douglas Mehr, M.D.
Ophthalmology
NPI 1720070899
3855 W 7800 S STE 100
West Jordan, UT 84088
(801) 260-0034
✔ PECOS✔ Accepts MedicareSame address
Rebekah Gensure, M.D., PH.D.
Ophthalmology
NPI 1225490444
755 E 3900 S
Salt Lake City, UT 84107
(801) 266-2283
✔ PECOS✔ Accepts Medicare7.3 mi

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

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2290249

Salt Lake Retina · West Jordan, UT
Active · expires Sep 21, 2027
CLIA Number46D2290249
Laboratory TypePhysician Office
Certificate Effective DateSeptember 22, 2025
Certificate Expiration DateSeptember 21, 2027
Laboratory DirectorAndrew Davis
Laboratory Phone(801) 260-0034
Laboratory LocationSalt Lake Retina3855 W 7800 S, #100, West Jordan, UT 84088
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2290245

Salt Lake Retina · Tooele, UT
Active · expires Sep 21, 2027
CLIA Number46D2290245
Laboratory TypePhysician Office
Certificate Effective DateSeptember 22, 2025
Certificate Expiration DateSeptember 21, 2027
Laboratory DirectorAndrew Davis
Laboratory Phone(801) 260-0034
Laboratory LocationSalt Lake Retina2376 N 400 E #100, Tooele, UT 84074
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2290252

Salt Lake Retina · West Valley City, UT
Active · expires Sep 21, 2027
CLIA Number46D2290252
Laboratory TypePhysician Office
Certificate Effective DateSeptember 22, 2025
Certificate Expiration DateSeptember 21, 2027
Laboratory DirectorAndrew Davis
Laboratory Phone(801) 260-0034
Laboratory LocationSalt Lake Retina3465 S 4155 W, #4, West Valley City, UT 84120
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Salt Lake Retina, LLC's NPI number?

The NPI number for Salt Lake Retina, LLC is 1144622234. It was assigned to this organization in the NPPES registry on September 19, 2014. The provider is doing business as Salt Lake Retina.

Where is Salt Lake Retina, LLC located?

Salt Lake Retina, LLC is located at 3855 W 7800 S Suite 100, West Jordan, UT 84088. The listed phone number is (801) 260-0034.

What is Salt Lake Retina, LLC's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Salt Lake Retina, LLC enrolled in Medicare?

Yes. Salt Lake Retina, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Salt Lake Retina, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Ophthalmology, reassign their Medicare billing to Salt Lake Retina, LLC. A 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 the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Salt Lake Retina, LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Salt Lake Retina, LLC accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Salt Lake Retina, LLC 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 Salt Lake Retina, LLC was last updated on April 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.