DR. KEVIN CLIFFORD SHOSTED O.D.
NPI 1164650685
Optometrist in Salt Lake City, UT

Q: What is Kevin Shosted's NPI number?

The NPI number for Kevin Shosted is 1164650685. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Q: What is Kevin Shosted's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kevin Shosted was last updated on May 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since June 23, 2009PECOS EnrolledAccepts Medicare Assignment

2828 W 4700 S, SUITE D, SALT LAKE CITY, UT 84118(801) 281-3937(801) 281-1430 Get Directions Write a Review

NPPES record last updated: May 4, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Dr. Kevin Clifford Shosted O.d. NPPES

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

DR. KEVIN CLIFFORD SHOSTED O.D. (NPI 1164650685) is an individual optometrist in Salt Lake City, Utah, licensed in Utah (7385204-9934) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (2009).

NPPES Registry Identity

NPI1164650685

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. KEVIN CLIFFORD SHOSTEDCredential: O.D.

Location Address2828 W 4700 S, SUITE DSalt Lake City, UT 84118-2154

Mailing Address2828 W 4700 S, Suite DSalt Lake City, UT 84118-2154 · (801) 281-3937 · Fax (801) 281-1430

Phone(801) 281-3937

Fax(801) 281-1430

Sole ProprietorYes

Medical School CMSPacific University - College Of OptometryGraduated 2009

Enumeration DateJune 23, 2009

Last NPPES UpdateMay 4, 2012

✔ NPI 1164650685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in UT · 7385204-9934

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.

2828 W 4700 S, Salt Lake City, UT 84118

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Clifford Shosted 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 ID9830237288

PECOS Enrollment IDI20091105000345

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 Reassignment

Medicare enrollment records show Kevin Shosted reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Focused Eyecare LLC

11 mi

Optometrist

5528 W 13400 S
Herriman, UT 84096

Reassigned Medicare billing, Utah enrollment
3 clinicians in this Medicare group

NPI 1558593145 (801) 302-3080

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 84118 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 4

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

TERRY M HANSEN OD LLC

Optometrist

2828 W 4700 S, SUITE D
SALT LAKE CITY, UT 84118

Salt Lake County (801) 966-6201

DR. ERIC J. HARRISON DC

Chiropractor

2828 W 4700 S, SUITE A
TAYLORSVILLE, UT 84118

Salt Lake County (801) 966-3101

DR. TRENT C HARRISON D.C.

Chiropractor

2828 W 4700 S, SUITE A
TAYLORSVILLE, UT 84118

Salt Lake County (801) 966-3101

HARRISON CHIROPRACTIC LLC

Chiropractor

2828 W 4700 S, SUITE A
TAYLORSVILLE, UT 84118

Salt Lake County (801) 966-3101

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 Kevin Shosted's NPI number?

The NPI number for Kevin Shosted is 1164650685. It was assigned to this individual provider in the NPPES registry on June 23, 2009.

Where is Kevin Shosted located?

Kevin Shosted practices at 2828 W 4700 S Suite D, Salt Lake City, UT 84118. The listed phone number is (801) 281-3937.

What is Kevin Shosted's specialty?

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

Is Kevin Shosted enrolled in Medicare?

Yes. Kevin Shosted 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 organization bills Medicare for Kevin Shosted's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Shosted reassigns Medicare benefits to Family Focused Eyecare LLC (Herriman, UT). The 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 Kevin Shosted's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Shosted 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 Providence Health Plan and 2 other insurers list Kevin Shosted 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 Kevin Shosted was last updated on May 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.