Jeffrey C Squire, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

657 Issued in MT

Practice address

1425 W Main St
Unit B
Bozeman, MT 59715-3283

Phone

(406) 586-2173

Fax

(406) 586-3603

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

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 and National Provider Directory roles.

• Eyes on Main Incorporated

  • Optometrist
  • Bozeman, MT
  • NPI 1316121627
  Medicare reassignment Authorized official
• Wellford Eye Center PLLC

  • Optometrist
  • Bozeman, MT
  • NPI 1275426025
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982766747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W MAIN ST",
            "address_2": "UNIT B",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153283",
            "telephone_number": "406-586-2173",
            "fax_number": "406-586-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W MAIN ST",
            "address_2": "UNIT B",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153283",
            "telephone_number": "406-586-2173",
            "fax_number": "406-586-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "248",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0000023861",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0483752",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1316121627",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phronsie Sprenger, LCSW
• Crystal Spring, RDH
• Marchelle Springer
• Sprout Oral Health
• Joshua Lupine Spuhler, PA-C
• Sarah Jayne St Clair, RDN
• Victoria N. St. Don, D.P.T.
• St. Vincent Healthcare
• Carol Burroughs Staben, LCPC
• Danielle Josephine Stack, LCPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.