Individual provider Active NPI

Jeffrey Donald Heninger, O.D.

  • Optometrist
  • Polson, MT
National Provider Identifier
1881894608
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
792 Issued in MT
Practice address
203A Ridgewater Dr
Polson, MT 59860-8992
Phone
(406) 883-4355
Fax
(406) 883-0702
NPI assigned
Jul 19, 2007
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 792 MT Primary

Addresses

Primary practice location

203A Ridgewater Dr
Polson, MT 59860-8992

Mailing address

203A Ridgewater Dr
Polson, MT 59860-8992
Phone (406) 883-4355

Other identifiers 2

IdentifierTypeStateIssuer
193200000XMedicaidMT
193400000XMedicaidMT

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
I20070828000128 MT Practitioner - Optometry 5890887467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeffrey D. Heninger, O.D. PLLCGroup PAC ID 1951494947, 2 clinicians

Practice addresses (Care Compare)

203 A Ridgewater Dr
Polson, MT 59860-8992
Phone (406) 883-4355

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey D. Heninger, O.D. PLLC Optometrist CurrentSince Aug 1, 2007 Accepting new patients

Locations

203A Ridgewater Dr
Polson, MT 59860
Phone (406) 883-4355

410 1st St E
Ste A
Polson, MT 59860
Phone (406) 872-2088

Organizations & group practices 1

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": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1881894608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203A RIDGEWATER DR",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608992",
            "telephone_number": "406-883-4355",
            "fax_number": "406-883-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203A RIDGEWATER DR",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608992",
            "telephone_number": "406-883-4355",
            "fax_number": "406-883-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENINGER",
        "first_name": "JEFFREY",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193200000X",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193400000X",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.