West Valley Vision Source – Optometrist, NPI 1427241843

West Valley Vision Source is a healthcare provider. based in Salt lake city, Utah. specializing in Optometrist. The organization holds a License No. 4942085-9934 (UT). The NPI Number for West Valley Vision Source is 1427241843

Main info

Organization
Name
West Valley Vision Source
NPI
1427241843
Phone
(801) 268-1200
Address
339 E 3900 S
Authorized Official
PAUL CHRISTIAN BRUDERER OWNER
Enumeration Date
20 August 2007
Last Update Date
4 February 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

Loading map...

Provider Addresses for West Valley Vision Source

  • 339, 3900 South, South Salt Lake, Salt Lake County, Utah, 84107, United States

    SUITE 150

    SALT LAKE CITY, UT 841071677

    Phone: (801) 268-1200

    Fax: (801) 268-1125

    Type: Mailing

  • 2782 S 5600 W STE 101

    WEST VALLEY CITY, UT 841205592

    Phone: (801) 969-9999

    Fax: (801) 746-1007

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2004-08-27

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
O20040827001055OClinic/Group PracticeUTTBD

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 84107)

Loading plans...

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

Is there an official ID for West Valley Vision Source in U.S. healthcare records?
The official identifier for West Valley Vision Source is NPI 1427241843.
Is there an active status for West Valley Vision Source?
For scheduling context, West Valley Vision Source is shown as active in the registry.
What expertise is attributed to West Valley Vision Source?
West Valley Vision Source's specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with West Valley Vision Source?
Directory geography for West Valley Vision Source centers on Salt Lake City, Utah.
Does West Valley Vision Source accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

Similar Providers

300 South, East Central, Salt Lake City, Salt Lake County, Utah, 84102, United States
NPI: 1124009824
300 South, East Central, Salt Lake City, Salt Lake County, Utah, 84102, United States
NPI: 1295716538
2319, Highland Drive, Sugar House, Salt Lake City, Salt Lake County, Utah, 84106, United States
NPI: 1265414569
300 South, East Central, Salt Lake City, Salt Lake County, Utah, 84102, United States
NPI: 1902889165
Costco, 1818, 300 West, Ballpark, Salt Lake City, Salt Lake County, Utah, 84115, United States
NPI: 1821076555
Los Altos Parkway, Sparks, Washoe County, Nevada, 89436, United States
NPI: 1730168071
328, Center Street, Capitol Hill, Salt Lake City, Salt Lake County, Utah, 84103, United States
NPI: 1851362339
Wasatch Vision Clinic, 849, 400 South, East Central, Salt Lake City, Salt Lake County, Utah, 84102, United States
NPI: 1720056161
S State St, Liberty Wells, Salt Lake City, Salt Lake County, Utah, 84114, United States
NPI: 1376503730