DR. DAVID D MORTENSEN (OD) – Optometrist, NPI 1871590430
Optometrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
| Company | Amount |
|---|---|
| SUN PHARMACEUTICAL INDUSTRIES INC. | $105 |
| Bausch & Lomb Americas Inc. | $34 |
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060128000034 | I | Optometry | UT | TBD |
| I20231206003888 | I | Optometry | TX | TBD |
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.
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
| Name | Specialty | State |
|---|---|---|
| O P T O M E T R Y | VA | |
| O P T O M E T R Y | UT | |
| O P T O M E T R Y | UT |
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