DR. RONALD KIRK (OD) – Optometrist, NPI 1780623595

DR. RONALD KIRK (OD) is a healthcare provider. based in Montezuma creek, Utah. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 112805-9934 (UT). The NPI Number for DR. RONALD KIRK (OD) is 1780623595

Main info

Male
40 Years Of Experience
Accepts Medicare Assignment
Name
DR. RONALD KIRK (OD)
NPI
1780623595
Phone
(435) 678-2324
Address
PO BOX 130
Enumeration Date
6 June 2006
Last Update Date
7 March 2022

Doctor Profile

Medical School Name
SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Secondary Phone
9286722498
Graduation Year
1986 (40 years ago)
PAC ID
5092982660
Group Practice PAC ID
1658275649
Professional Enrollment ID
I20120209000693
Address ID
UT845113910NA2XXXXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

312 OPTOMETRY in UT

Provider Addresses for DR. RONALD KIRK (OD)

  • PO BOX 130

    MONTEZUMA CREEK, UT 845340130

    Phone: (435) 678-2324

    Fax: (435) 678-3344

    Type: Mailing

  • 910 S 300 W

    BLANDING, UT 845113921

    Phone: (435) 678-2324

    Fax: (435) 678-3344

    Type: Location

  • 46, North Main Street, Blanding, San Juan County, Utah, 84511, United States

    BLANDING, UT 845112830

    Phone: (435) 678-2324

    Fax: (435) 678-3344

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-02-09

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
I20120209000693IOptometryUTTBD

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
66984Removal of cataract with insertion of prosthetic lens3025$0
View full utilization report →

Insurance plans in this area (ZIP 84534)

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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: 1658275649View full group profile
NameSpecialtyState
Family PracticeMT
P S Y C H I A T R YUT
Physician AssistantUT
Clinical Social WorkerUT
Nurse PractitionerUT
O P T O M E T R YUT
Physician AssistantUT
Physician AssistantUT
Physician AssistantUT
Physician AssistantUT

Reviews

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Frequently asked questions

What is DR. RONALD KIRK (OD)'s NPI number?
DR. RONALD KIRK (OD)'s NPI is 1780623595 — the number used across U.S. healthcare to identify this provider.
Would DR. RONALD KIRK (OD) appear as active to a payer?
You can treat DR. RONALD KIRK (OD) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for DR. RONALD KIRK (OD)?
At a glance, DR. RONALD KIRK (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. RONALD KIRK (OD) associated with Montezuma Creek?
Public fields place DR. RONALD KIRK (OD) around Montezuma Creek, Utah. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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