Jacob Dilworth

Primary specialty

OptometristTaxonomy code 152W00000X

License

5587 Issued in MT

Practice address

203A Ridgewater Dr
Polson, MT 59860-8992

Phone

(406) 883-4355

NPI assigned

Jun 17, 2025

Last updated

Jun 17, 2025By 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 1

Addresses

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

Specialty

Optometry

Education

Other, 2025

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jeffrey D. Heninger, O.D. PLLC

  dba Polson Family Eyecare

  • Optometrist
  • Polson, MT
  • NPI 1831382605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1902792849",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILWORTH",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "5587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Alyse Day, SNM
• Dci Kidney Care Polson LLC
• Katherine Jean Devlin, PHARMD
• Dialysis Clinic Inc
• Cynthia A Difrancesco, PT
• Dogwood Counseling PLLC
• Siera Leone Donovan, PCLC
• Dr. Michael R. Windauer, DMD, PC
• Dr. Vincent River, P.C.
• Ken Druyvestein, RPH

• Optometrist in Polson, MT
• Providers in Polson, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.