DR. DAVID D MORTENSEN (OD) – Optometrist, NPI 1871590430

DR. DAVID D MORTENSEN (OD) is a healthcare provider. based in Clinton, Utah. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 0601800582 (VA). The NPI Number for DR. DAVID D MORTENSEN (OD) is 1871590430

Main info

Male
Sole Proprietor
28 Years Of Experience
Name
DR. DAVID D MORTENSEN (OD)
NPI
1871590430
Phone
(801) 779-0708
Address
2028 W 2220 N
Enumeration Date
28 June 2005
Last Update Date
24 October 2024

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
1998 (28 years ago)
PAC ID
0648175299
Group Practice PAC ID
3375602790
Professional Enrollment ID
I20060128000034
Address ID
UT840158388Cl2028X2220300
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. DAVID D MORTENSEN (OD)

  • 2028 W 2220 N

    CLINTON, UT 840155744

    Phone: (801) 779-0708

    Fax: (385) 393-7875

    Type: Mailing

  • Bracken Parkway, Hobart, Lake County, Indiana, 46342, United States

    HOBART, IN 463426879

    Phone: (219) 942-1369

    Fax: (219) 226-9547

    Type: Mailing

  • North Main Street, Crown Point, Lake County, Indiana, 46307, United States

    CROWN POINT, IN 46307

    Phone: (219) 226-9571

    Fax: (219) 226-9547

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $139.

Total Amount is formed as General ($139) + Research ($0) + Ownership ($0) = $139.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: SUN PHARMACEUTICAL INDUSTRIES INC. ($105).

Total Amount

$139

General + Research + Ownership

Payments

3

Total payment records

General Amount

$139

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

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: 2023-12-06

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
I20060128000034IOptometryUTTBD
I20231206003888IOptometryTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84015)

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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: 3375602790View full group profile
NameSpecialtyState
O P T O M E T R YVA
O P T O M E T R YUT
O P T O M E T R YUT

Reviews

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Frequently asked questions

Is DR. DAVID D MORTENSEN (OD) listed with a National Provider Identifier?
Yes — DR. DAVID D MORTENSEN (OD) has NPI 1871590430 on file in the registry.
Is there an active status for DR. DAVID D MORTENSEN (OD)?
For scheduling context, DR. DAVID D MORTENSEN (OD) is shown as active in the registry.
What clinical focus is listed for DR. DAVID D MORTENSEN (OD)?
At a glance, DR. DAVID D MORTENSEN (OD) is tied to Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. DAVID D MORTENSEN (OD) located near Clinton?
DR. DAVID D MORTENSEN (OD) currently maps to Clinton, Utah in this extract.
Does DR. DAVID D MORTENSEN (OD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.