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Kevin Mark Ellsworth, O.D.

NPI 1669457024ActiveIndividual· Optometrist· Logan, UT

Optometrist (O.D.) in Logan, Utah, trained at Southern California College of Optometry (class of 1985). 115 Medicare patients in 2024, $11,838 paid; nearly all of their 89 Part D prescriptions were generic (91%).

Overview

NPI1669457024
StatusActive
Entity typeIndividual
CredentialO.D.
Sole proprietorYes
NPI issuedDec 8, 2005
Last updated in NPPESAug 20, 2008

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X112376-9934UT

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Optometry (UT)
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients115
Services billed247 across 7 procedure codes
Paid by Medicare$11,838

Part D prescriptions in 2024

Prescriptions (claims)89 · 149 30-day fills
Patients24
Total drug cost$2,315
Generic share91% of claims

Medicare sources and data years

Education and affiliations

Medical schoolSouthern California College of Optometry
Graduation year1985
Medicare specialtyOptometry

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Optometrist providers in Logan

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