1. Home
  2. Directory
  3. Utah
  4. Logan
  5. Optometrist
  6. NPI Profile

AEG UTAH PROFESSIONAL INC
NPI 1154212777
Optometrist in Logan, UT

Active since July 11, 2025
1300 N 200 E STE 104, LOGAN, UT 84341(435) 752-6453 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Aeg Utah Professional Inc NPPES

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

AEG UTAH PROFESSIONAL INC (NPI 1154212777) is a healthcare organization registered as an optometrist in Logan, Utah and active in the NPI registry since July 2025. The organization lists Melissa Allison, Sr. Director Managed Vision Care, as its authorized official.

NPPES Registry Identity

NPI1154212777
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameAEG UTAH PROFESSIONAL INC
Location Address1300 N 200 E STE 104Logan, UT 84341-2460
Mailing Address111 E 4th St Ste 440Alton, IL 62002-6206
Phone(435) 752-6453
Organization SubpartNo
Authorized OfficialMelissa AllisonSr. Director Managed Vision Care · (618) 604-5208
Enumeration DateJuly 11, 2025
NPPES CertifiedJuly 11, 2025
✔ NPI 1154212777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
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.
1300 N 200 E STE 104, Logan, UT 84341
Open in Google Maps ↗

Group Practice 1

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 Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Aeg Utah Professional Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Aeg Utah Professional Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (10)

Jeffrey Cromwell, O.D.
Optometry
NPI 1801902333
1300 N 200 E SUITE 104
Logan, UT 84341
(435) 752-6453
✔ PECOS✔ Accepts MedicareSame address
Michael Cole, O.D.
Optometry
NPI 1689970667
981 S MAIN ST STE 220
Logan, UT 84321
(435) 363-2980
✔ PECOS✔ Accepts Medicare4.6 mi
Callin Passey, OD
Optometry
NPI 1508020363
517 W 100 N STE 110
Providence, UT 84332
(435) 755-6075
✔ PECOS✔ Accepts Medicare4.8 mi
Lance Henderson
Optometry
NPI 1225186398
134 N STATE ST
Preston, ID 83263
(208) 852-3030
✔ PECOS✔ Accepts Medicare23 mi
Songhwa Choi, O. D.
Optometry
NPI 1811348410
1761 N 2000 W
Ogden, UT 84404
(801) 731-5558
✔ PECOS✔ Accepts Medicare37 mi
Todd Mumford, O.D.
Optometry
NPI 1255412771
1741 N 2000 W
Farr West, UT 84404
(017) 315-5558
✔ PECOS✔ Accepts Medicare38 mi
Tyrell Yardley, OD
Optometry
NPI 1578269767
4360 WASHINGTON BLVD
Ogden, UT 84403
(801) 476-0949
✔ PECOS✔ Accepts Medicare41 mi
Chelle Nickle, O.D.
Optometry
NPI 1144303983
57 N MAIN ST
Farmington, UT 84025
(801) 447-4393
✔ PECOS✔ Accepts Medicare55 mi
Paul Bruderer, O.D.
Optometry
NPI 1316956576
2782 S 5600 W STE 101
West Valley City, UT 84120
(801) 969-9999
✔ PECOS✔ Accepts Medicare75 mi
Bradley Fellows, O.D.
Optometry
NPI 1841473295
9035 S 1300 E
Sandy, UT 84094
(801) 566-4119
✔ PECOS82 mi

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

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 Aeg Utah Professional Inc's NPI number?

The NPI number for Aeg Utah Professional Inc is 1154212777. It was assigned to this organization in the NPPES registry on July 11, 2025.

Where is Aeg Utah Professional Inc located?

Aeg Utah Professional Inc is located at 1300 N 200 E Ste 104, Logan, UT 84341. The listed phone number is (435) 752-6453.

What is Aeg Utah Professional Inc's specialty?

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

Is Aeg Utah Professional Inc enrolled in Medicare?

Yes. Aeg Utah Professional Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Aeg Utah Professional Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians, all in Optometry, reassign their Medicare billing to Aeg Utah Professional Inc. 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, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Aeg Utah Professional Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BridgeSpan Health Company and 1 other insurer list Aeg Utah Professional Inc 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 Aeg Utah Professional Inc was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.