Powder Basin Eyepros – Optometrist, NPI 1467203539

Powder Basin Eyepros is a healthcare provider. based in Liberty, Utah. specializing in Optometrist. The NPI Number for Powder Basin Eyepros is 1467203539

Main info

Organization
Name
Powder Basin Eyepros
NPI
1467203539
Phone
(267) 736-6335
Address
4523 N 3150 E
Authorized Official
RYAN GRANT HAYES OWNER OD
Enumeration Date
28 March 2024
Last Update Date
28 March 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness80
Years active:2State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Powder Basin Eyepros

  • 4523 N 3150 E

    LIBERTY, UT 843109799

    Phone: (267) 736-6335

    Type: Mailing

  • 2143 N 5500 E

    EDEN, UT 84310

    Phone: (267) 736-6335

    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: 2024-10-25

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
O20241025003730OClinic/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 84310)

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Reviews

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Frequently asked questions

What is Powder Basin Eyepros's NPI number?
Powder Basin Eyepros's NPI is 1467203539 — the number used across U.S. healthcare to identify this provider.
Is Powder Basin Eyepros still an active registrant?
Powder Basin Eyepros carries an active NPI according to the public dataset.
What expertise is attributed to Powder Basin Eyepros?
Powder Basin Eyepros's specialty line reads Optometrist. Clinical services aligned with this taxonomy classification.
Where in Utah is Powder Basin Eyepros registered?
Use Liberty, Utah as the headline location for Powder Basin Eyepros here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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