Stewart Jerome Hazel, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MED-PHYS-LIC-28392 Issued in MT

Practice address

3328 S 30TH Ave
Bozeman, MT 59718-3709

Phone

(218) 349-0870

NPI assigned

Jun 10, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013958958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 S 30TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183709",
            "telephone_number": "218-349-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3328 S 30TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183709",
            "telephone_number": "218-349-0870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016101",
            "country_code": "US",
            "telephone_number": "171-583-8363",
            "fax_number": "715-838-3635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZEL",
        "first_name": "STEWART",
        "middle_name": "JEROME",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "29754",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "MD20120733",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "35040-20",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MT",
            "license": "MED-PHYS-LIC-28392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "849792300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Ophthalmology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.