DR. KENYON B ANDERSON (O.D.) – Optometrist, NPI 1043280555

DR. KENYON B ANDERSON (O.D.) is a healthcare provider. based in Santaquin, Utah. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 8897506 (UT). The NPI Number for DR. KENYON B ANDERSON (O.D.) is 1043280555

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENYON B ANDERSON (O.D.)
NPI
1043280555
Phone
(801) 609-2020
Address
252 W Main St Ste C
Enumeration Date
25 January 2006
Last Update Date
22 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
9073762020
Graduation Year
2005 (21 years ago)
PAC ID
9537187547
Group Practice PAC ID
7012032949
Professional Enrollment ID
I20250424002984
Address ID
AK996548425WA4505XCIRX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience82
Completeness75
Years active:20State licenses:3Digital endpointsOther names

312 OPTOMETRY in UT

Provider Addresses for DR. KENYON B ANDERSON (O.D.)

  • 252 W Main St Ste C

    Santaquin, UT 84655

    Phone: (801) 609-2020

    Type: Location

  • 4505 E Greenstreet Cir

    Wasilla, AK 996548425

    Phone: (907) 376-2020

    Type: Location

  • 252 W MAIN ST STE C

    SANTAQUIN, UT 846557086

    Phone: (801) 609-2020

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 27 Open Payments records for all available years, with a total value of $3,115.

Total Amount is formed as General ($3,115) + Research ($0) + Ownership ($0) = $3,115.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: CooperVision Inc. ($2,307).

Total Amount

$3,115

General + Research + Ownership

Payments

27

Total payment records

General Amount

$3,115

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140627000175IOptometryUTTBD
I20250424002984IOptometryAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92014Established patient complete exam of visual system157110$0
92134Imaging of retina4338$0
92133Imaging of optic nerve3230$0
92004New patient complete exam of visual system3131$0
92083Exam of visual field with extended testing2827$0
View full utilization report →

Insurance plans in this area (ZIP 84655)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012032949View full group profile
NameSpecialtyState
O P T O M E T R YAK
O P H T H A L M O L O G YAK
O P T O M E T R YKY
O P T O M E T R YAK
O P H T H A L M O L O G YAK
O P T O M E T R YAK
O P T O M E T R YKY
O P T O M E T R YAK

Reviews

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Frequently asked questions

Can I use this page to confirm DR. KENYON B ANDERSON (O.D.)'s NPI?
Yes. DR. KENYON B ANDERSON (O.D.) is listed with NPI 1043280555 in the public NPI dataset.
Can I rely on DR. KENYON B ANDERSON (O.D.) being an active provider?
As of the registry snapshot, DR. KENYON B ANDERSON (O.D.) is marked active.
What is DR. KENYON B ANDERSON (O.D.)'s specialty?
The listing groups DR. KENYON B ANDERSON (O.D.) with Optometrist. Clinical services aligned with this taxonomy classification.
Does DR. KENYON B ANDERSON (O.D.) list a practice location?
Patients near Santaquin, Utah may find DR. KENYON B ANDERSON (O.D.) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.