Individual provider Active NPI

Jennifer H. Dull, O.D.

  • Optometrist
  • Billings, MT
National Provider Identifier
1124165618
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
747 Issued in MT
Practice address
430 Lake Elmo Dr
Billings, MT 59105-3066
Phone
(406) 252-9927
NPI assigned
Jan 31, 2007
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 747 MT Primary

Addresses

Primary practice location

430 Lake Elmo Dr
Billings, MT 59105-3066

Mailing address

430 Lake Elmo Dr
Billings, MT 59105-3066
Phone (406) 252-9927

Other identifiers 5

IdentifierTypeStateIssuer
28371OtherMTBCBS
P00738886OtherMTRAILROAD MEDICARE
000084260OtherMTMEDICARE GROUP
0483412MedicaidMT
011001901OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000774 MT Practitioner - Optometry 0446142921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heights Eyecare, Inc.Group PAC ID 7810957495, 6 clinicians

Practice addresses (Care Compare)

430 Lake Elmo Dr
Billings, MT 59105-3037
Phone (406) 252-9927

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
747MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heights Eyecare, Inc. Optometrist CurrentSince Aug 13, 2008 Accepting new patients
Southern Montana Optometric Center, Inc Optometrist Past Accepting new patients

Locations

430 Lake Elmo Dr
Billings, MT 59105
Phone (406) 252-9927

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1124165618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 LAKE ELMO DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053066",
            "telephone_number": "406-252-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 LAKE ELMO DR",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591053066",
            "telephone_number": "406-252-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULL",
        "first_name": "JENNIFER",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28371",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00738886",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "000084260",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483412",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "011001901",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.