MR. SCOTT H KOWALLIS O.D.
NPI 1861487050
Optometrist in Roosevelt, UT

Q: What is Scott Kowallis's NPI number?

The NPI number for Scott Kowallis is 1861487050. It was assigned to this individual provider in the NPPES registry on September 14, 2005.

Q: What is Scott Kowallis'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 Scott Kowallis was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 September 14, 2005PECOS Enrolled

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

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Mr. Scott H Kowallis O.d. NPPES

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

MR. SCOTT H KOWALLIS O.D. (NPI 1861487050) is an individual optometrist in Roosevelt, Utah, licensed in Utah (111999-9934) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861487050

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameMR. SCOTT H KOWALLISCredential: O.D.

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

Phone(435) 722-2981

Fax(435) 722-3732

Sole ProprietorNo

Enumeration DateSeptember 14, 2005

Last NPPES UpdateJune 18, 2008

✔ NPI 1861487050 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

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Other Identifiers 13

Other000009840UT · Medicare Legacy Number

Other1015UT · Opticare

Other87041538400001UT · Valucare

Other870444057Vsp

Other87041538400001UT · Bcbs

Other12466Pehp

Other87041538400001Ntca

Other00437Va

Other107009195101Ihc

OtherUT1999Eyemed

Other123252Mba

Medicare UPINT78179UT

Other870444057K02Educator's Mutual

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Scott H Kowallis 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 Scott Kowallis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Roosevelt Vision Clinic, PC

6.4 mi

Optometrist

165 W 200 N, 71-7
Roosevelt, UT 84066

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

NPI 1710973052 (435) 722-2981

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 84066 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.

ROOSEVELT VISION CLINIC, PC

Optometrist

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

Duchesne County (435) 722-2981

JON PRESTON WILSON O.D.

Optometrist

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

Duchesne County (435) 722-2981

CARSON DAYTON SUMMERS OD

Optometrist

165 W 200 N
ROOSEVELT, UT 84066

Duchesne County (435) 722-2981

JASON KOWALLIS OD

Optometrist

165 W 200 N
ROOSEVELT, UT 84066

Duchesne County (435) 722-5890

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 Scott Kowallis's NPI number?

The NPI number for Scott Kowallis is 1861487050. It was assigned to this individual provider in the NPPES registry on September 14, 2005.

Where is Scott Kowallis located?

Scott Kowallis practices at 165 W 200 N 71-7, Roosevelt, UT 84066. The listed phone number is (435) 722-2981.

What is Scott Kowallis's specialty?

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

Is Scott Kowallis enrolled in Medicare?

Yes. Scott Kowallis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Scott Kowallis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Scott Kowallis reassigns Medicare benefits to Roosevelt Vision Clinic, PC (Roosevelt, 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 Scott Kowallis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Scott Kowallis was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.