Individual provider Active NPI

Chad Krezelok, O.D.

  • Optometrist
  • Bozeman, MT
National Provider Identifier
1285799650
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
782 Issued in MT
Practice address
1500 N 7TH Ave
Bozeman, MT 59715-2557
Phone
(406) 585-8153
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 782 MT Primary

Addresses

Primary practice location

1500 N 7TH Ave
Bozeman, MT 59715-2557

Mailing address

17 E Story St Apt 1
Bozeman, MT 59715-4881
Phone (307) 752-7118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170113001494 MT Practitioner - Optometry 6709167638 Reassigns benefits to 1 organization
I20180108000405 TX Practitioner - Optometry 6709167638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shoshone TribeGroup PAC ID 7810422193, 17 clinicians

Practice addresses (Care Compare)

PO Box
Suite 128
Fort Washakie, WY 82514-0128
Phone (307) 332-7300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
782MTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Professionals - Mountain Eyewear Optometrist CurrentSince Nov 12, 2021 Accepting new patients
Eastern Shoshone Tribe Optometrist CurrentSince Mar 15, 2025 Accepting new patients
Wind River Family & Community Healthc Care CurrentSince Oct 21, 2017 Accepting new patients
Christopher L Paris M D P C PastSince Nov 12, 2021 Accepting new patients

Locations

1500 N 7th Ave
Bozeman, MT 59715
Phone (406) 585-8753

305 W Park St
Livingston, MT 59047
Phone (406) 222-0205

14 Great Plains Rd
Arapahoe, WY 82510

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285799650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E STORY ST APT 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154881",
            "telephone_number": "307-752-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 7TH AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597152557",
            "telephone_number": "406-585-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREZELOK",
        "first_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.