Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104816743 Individual Practitioner Male Practitioner

Dr. Roy Raymond Gibson , OD

Optometrist • Riverdale, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Roy Gibson, OD is a certified Optometrist practicing in Riverdale, UT. With approximately 41 years of clinical experience since graduating from University Of Houston - College Of Optometry in 1985, Dr. Gibson delivers high-quality medical care to the local community at 4949 S 900 W.

Dr. Gibson maintains professional affiliations with Eye Pros Of Layton Llc, Eye Pros Of Ogden and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4949 S 900 W

Riverdale, UT 844053777

Telephone 8016210480
Fax 8016123485
Associated Practice Facility / Clinic
🏢 Sams West Inc Facility NPI 1053339804

Medicare Profile & Education

Medical School

University Of Houston - College Of Optometry

Graduation Year

1985

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Riverdale, UT

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
41 Yrs Matches City Avg
City Avg: 41.0 Yrs
State Avg: 19.7 Yrs
Regional Practice Density
2 Specialists

Practicing in Riverdale, UT (484 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
46.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gibson (41 Years) 41 Yrs
Riverdale Specialty Average (41.0 Years) 41.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
36 35 $230.00 $122.10
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
15 15 $300.00 $159.20

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License UT 1130289934

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Optometrist

NUCC Taxonomy Code: 152W00000X

State License UT 1130288904

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID First Health Network
1737499 (UT)
Commercial Insurance / Payer ID Dmba
589803 (UT)
Commercial Insurance / Payer ID Caqh
11445324 (UT)
Commercial Insurance / Payer ID Pehp
81820 (UT)

Hospital & Practice Group Affiliations

Eye Pros Of Ogden

4115 Riverdale Rd, Riverdale, UT 844053509

Phone: 8337762020

Eye Pros Of Layton Llc

1986 N Hill Field Rd, Layton, UT 840412109

Phone: 8337762020

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1669078739

Registered Pharmacist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2026

Optometrist (License #1130289934 in UT)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 4949 S 900 W, RIVERDALE, UT 844053777 (Tel: 8016210480)

📍
Updated Business Mailing Address July 08, 2007

Registered at 5690 S 3750 W, ROY, UT 840678161 (Tel: 8019854141)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as ROY GIBSON, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #1130289934 in UT)

🟢
Initial NPI Registration & Enumeration October 25, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104816743
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 25, 2005
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

5690 S 3750 W

Roy, UT 840678161

Phone: 8019854141

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.