ROOSEVELT VISION CLINIC, PC
NPI 1710973052
Optometrist in Roosevelt, UT

Active since September 22, 2005
165 W 200 N, 71-7, ROOSEVELT, UT 84066(435) 722-2981(435) 722-3732 Get Directions Write a Review

NPPES record last updated: August 27, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Roosevelt Vision Clinic, Pc NPPES

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

ROOSEVELT VISION CLINIC, PC (NPI 1710973052) is a healthcare organization registered as an optometrist in Roosevelt, Utah and active in the NPI registry since September 2005. The organization lists Scott H Kowallis, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1710973052
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameROOSEVELT VISION CLINIC, PC
Location Address165 W 200 N, 71-7Roosevelt, UT 84066-2834
Mailing Address165 W 200 N, 71-7Roosevelt, UT 84066-2834 · (435) 722-2981 · Fax (435) 722-3732
Fax(435) 722-3732
Organization SubpartNo
Authorized OfficialScott H KowallisOwner/doctor · (435) 722-2981
Enumeration DateSeptember 22, 2005
Last NPPES UpdateAugust 27, 2008
NPI 1710973052 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 · 111999-9934
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.
165 W 200 N, Roosevelt, UT 84066

Other Identifiers 1

Medicare NSC0536370001UT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Roosevelt Vision Clinic carries, from the Medicare DMEPOS supplier directory.

Roosevelt Vision Clinic

DMEPOS supplier · Roosevelt, UTOperated by Roosevelt Vision Clinic PC

Accepts Medicare assignment

Roosevelt Vision Clinic agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20556587
Medicare Participant SinceSeptember 1, 2008
Supplier Location165 W 200 N # 71-7Roosevelt, UT 84066
Supplier Specialties
Optometrist Optician

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Unknown
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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.

Optometrist
165 W 200 N, 71-7
ROOSEVELT, UT 84066
Optometrist
165 W 200 N, 71-7
ROOSEVELT, UT 84066
Optometrist
165 W 200 N
ROOSEVELT, UT 84066

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 Roosevelt Vision Clinic, PC's NPI number?

The NPI number for Roosevelt Vision Clinic, PC is 1710973052. It was assigned to this organization in the NPPES registry on September 22, 2005.

Where is Roosevelt Vision Clinic, PC located?

Roosevelt Vision Clinic, PC is located at 165 W 200 N 71-7, Roosevelt, UT 84066. The listed phone number is (435) 722-2981.

What is Roosevelt Vision Clinic, PC's specialty?

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

Does Roosevelt Vision Clinic, PC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Roosevelt Vision Clinic accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Roosevelt Vision Clinic, PC accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, BlueCross BlueShield of Tennessee, Molina Healthcare and University of Utah Health Plans list Roosevelt Vision Clinic, PC 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 Roosevelt Vision Clinic, PC was last updated on August 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.