TANNON BRADLEY (OD) – Optometrist, NPI 1972297109

TANNON BRADLEY (OD) is a healthcare provider. based in Springville, Utah. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 13442708-9934 (UT). The NPI Number for TANNON BRADLEY (OD) is 1972297109

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
TANNON BRADLEY (OD)
NPI
1972297109
Phone
(801) 489-5111
Address
374 E 400 S Ste 1
Enumeration Date
8 June 2023
Last Update Date
8 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8013774333
Graduation Year
2023 (3 years ago)
PAC ID
4688035868
Group Practice PAC ID
1658274899
Professional Enrollment ID
I20230803003579
Address ID
UT846042721PR1355XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

312 OPTOMETRY in UT

Provider Addresses for TANNON BRADLEY (OD)

  • 374 E 400 S Ste 1

    Springville, UT 846631975

    Phone: (801) 489-5111

    Type: Location

  • 1355 N UNIVERSITY AVE STE 100

    PROVO, UT 846042721

    Phone: (801) 377-4333

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $173.

Total Amount is formed as General ($173) + Research ($0) + Ownership ($0) = $173.

Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Alcon Vision LLC ($128).

Total Amount

$173

General + Research + Ownership

Payments

8

Total payment records

General Amount

$173

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-28

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: 2023-08-03

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
I20230803003579IOptometryUTTBD

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 84663)

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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: 1658274899View full group profile
NameSpecialtyState
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

How do I look up TANNON BRADLEY (OD) by NPI?
Use NPI 1972297109 when you need to reference TANNON BRADLEY (OD) in forms, claims, or directories.
Does this profile mean TANNON BRADLEY (OD) is currently active?
Yes — TANNON BRADLEY (OD) appears active in the national provider directory.
What does TANNON BRADLEY (OD) treat or focus on?
Patients typically see TANNON BRADLEY (OD) under the specialty Optometrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for TANNON BRADLEY (OD)?
The page summarizes Springville, Utah for TANNON BRADLEY (OD); expand the address list for detail.
Is TANNON BRADLEY (OD) a real provider?
This page reflects official NPPES data for NPI 1972297109. Always confirm identity and privileges with the practice and licensing boards.

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