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DR. JOHN ELLISON O.D.
NPI 1376713586
Optometrist in Roy, UT

Active since March 04, 2008PECOS Enrolled

NPPES record last updated: November 12, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. John Ellison O.d. NPPES

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

DR. JOHN ELLISON O.D. (NPI 1376713586) is an individual optometrist in Roy, Utah, licensed in Utah (6617396-9934) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376713586
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JOHN ELLISONCredential: O.D.
Location Address5421 S 1900 WRoy, UT 84067-2908
Mailing Address5421 S 1900 WRoy, UT 84067-2908 · (801) 825-9703
Phone(801) 825-9703
Sole ProprietorNo
Enumeration DateMarch 4, 2008
Last NPPES UpdateNovember 12, 2018
✔ NPI 1376713586 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 · 6617396-9934
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.
5421 S 1900 W, Roy, UT 84067
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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 Louisiana, Blue Cross and Blue Shield of Montana 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 (PECOS)

Dr. John Ellison O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 John Ellison reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Standard Optical Co
1.4 mi
Optometrist
5421 S 19TH W
Roy, UT 84067
  • Reassigned Medicare billing, Utah enrollment
  • 25 clinicians in this Medicare group
NPI 1396832655 (801) 825-9703

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 84067 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.

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 John Ellison's NPI number?

The NPI number for John Ellison is 1376713586. It was assigned to this individual provider in the NPPES registry on March 4, 2008.

Where is John Ellison located?

John Ellison practices at 5421 S 1900 W, Roy, UT 84067. The listed phone number is (801) 825-9703.

What is John Ellison's specialty?

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

Is John Ellison enrolled in Medicare?

Yes. John Ellison is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Ellison's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Ellison reassigns Medicare benefits to Standard Optical Co (Roy, 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 John Ellison's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Ellison accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 1 other insurer list John Ellison 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 John Ellison was last updated on November 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.