DR. DAVID D MORTENSEN OD
NPI 1871590430
Optometrist in Clinton, UT
About Dr. David D Mortensen Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DAVID D MORTENSEN OD (NPI 1871590430) is an individual optometrist in Clinton, Utah, licensed in Utah (361378-9934) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (1998).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted 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. David D Mortensen Od is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show David Mortensen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Clinton, UT 84015
- Reassigned Medicare billing, Utah enrollment
- 6 clinicians in this Medicare group
Salt Lake City, UT 84111
- Reassigned Medicare billing, Texas enrollment
- 72 clinicians in this Medicare group
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 84015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 David Mortensen's NPI number?
The NPI number for David Mortensen is 1871590430. It was assigned to this individual provider in the NPPES registry on June 28, 2005.
Where is David Mortensen located?
David Mortensen practices at 2028 W 2220 N, Clinton, UT 84015. The listed phone number is (801) 779-0708.
What is David Mortensen's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is David Mortensen enrolled in Medicare?
Yes. David Mortensen is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for David Mortensen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Mortensen reassigns Medicare benefits to 2 organizations: Promontory Vision Partners (Clinton, UT) and Confederated Tribes Of The Goshute Reservation (Salt Lake City, UT). Each 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 David Mortensen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Mortensen 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 4 other insurers list David Mortensen 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 David Mortensen was last updated on October 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Dr. David D Mortensen, OD · NPI 1871590430
Optometrist provider in Clinton, Utah. Individual provider, active in the CMS NPPES registry since June 28, 2005.
## Identity
- **NPI:** 1871590430 (Entity type: Individual)
- **Enumerated:** June 28, 2005
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 361378-9934 (Utah)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2028 W 2220 N, Clinton, UT 84015-5744
- **Phone:** (801) 779-0708 · **Fax:** (385) 393-7875
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Promontory Vision Partners (NPI 1013187822, Clinton, UT); Confederated Tribes Of The Goshute Reservation (NPI 1992141964, Salt Lake City, UT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Southern College Of Optometry, class of 1998
## Record status
- **NPPES last updated:** October 24, 2024
- **Other identifiers:** Other 162686 (VA); Other P00190241 (VA); Medicaid 010118166 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1871590430) · Data from the CMS NPPES public registry.