ROY RAYMOND GIBSON (O.D.) – Optometrist, NPI 1104816743

ROY RAYMOND GIBSON (O.D.) is a healthcare provider. based in Roy, Utah. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 1130289934 (UT). The NPI Number for ROY RAYMOND GIBSON (O.D.) is 1104816743

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
ROY RAYMOND GIBSON (O.D.)
NPI
1104816743
Phone
(801) 985-4141
Address
5690 S 3750 W
Enumeration Date
25 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
8337762020
Graduation Year
1985 (41 years ago)
PAC ID
5294725834
Group Practice PAC ID
1355680851
Professional Enrollment ID
I20040514001008
Address ID
UT840412109LA1986XRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:20State licenses:2Digital endpointsOther names

312 OPTOMETRY in UT

Loading map...

Provider Addresses for ROY RAYMOND GIBSON (O.D.)

  • 5690, South 3750 West, Roy, Weber County, Utah, 84067, United States

    ROY, UT 840678161

    Phone: (801) 985-4141

    Fax: (801) 985-4242

    Type: Mailing

  • Sam's Club, 4949, South 900 West, Riverdale, Weber County, Utah, 84405, United States

    RIVERDALE, UT 844053777

    Phone: (801) 621-0480

    Fax: (801) 612-3485

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $219.

Total Amount is formed as General ($219) + Research ($0) + Ownership ($0) = $219.

Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($161).

Total Amount

$219

General + Research + Ownership

Payments

6

Total payment records

General Amount

$219

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-28

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: 2004-05-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20040514001008IOptometryUTTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes4242$0
92134Imaging of retina1515$0
99204New patient office or other outpatient visit, 45-59 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 84067)

Loading plans...

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: 1355680851View full group profile
NameSpecialtyState
O P T O M E T R YUT
O P T O M E T R YOR
O P T O M E T R YUT

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is ROY RAYMOND GIBSON (O.D.)'s NPI number?
ROY RAYMOND GIBSON (O.D.)'s NPI is 1104816743 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to ROY RAYMOND GIBSON (O.D.)?
You should see ROY RAYMOND GIBSON (O.D.) as active in CMS-hosted NPPES data.
How would a patient describe ROY RAYMOND GIBSON (O.D.)'s focus?
For ROY RAYMOND GIBSON (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is ROY RAYMOND GIBSON (O.D.) associated with Roy?
Public fields place ROY RAYMOND GIBSON (O.D.) around Roy, Utah. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.