Individual provider Active NPI

John Earl Kaminski, OD

  • Optometrist
  • Midland, MI
National Provider Identifier
1003811605
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004014 Issued in MI
Practice address
1504 Harcrest Dr
Midland, MI 48640-4717
Phone
(989) 636-7580
Fax
(989) 636-7583
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004014 MI Primary
Low Vision Rehabilitation Optometrist 152WL0500X 4901004014 MI

Addresses

Primary practice location

1504 Harcrest Dr
Midland, MI 48640-4717

Mailing address

1504 Harcrest Dr
Midland, MI 48640-4717
Phone (989) 636-7580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050722000314 MI Practitioner - Optometry 1759318678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott M. Buckingham, OD PCGroup PAC ID 3476630112, 2 clinicians

Practice addresses (Care Compare)

2808 W Wackerly St
Suite 1
Midland, MI 48640-6997
Phone (989) 636-7580

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4901004014MIMDLow Vision Rehabilitation Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott M. Buckingham, OD PC Optometrist CurrentSince Apr 1, 2008 Accepting new patients
Buckingham and Kaminski PLC Optometrist Past Accepting new patients
Central Eye Consultants, P.C. Past Accepting new patients

Locations

2808 W Wackerly St
Ste 1
Midland, MI 48640
Phone (989) 631-0930

1504 Harcrest Dr
Ste 3
Midland, MI 48640
Phone (989) 636-7580

Organizations & group practices 3

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003811605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 HARCREST DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404717",
            "telephone_number": "989-636-7580",
            "fax_number": "989-636-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 HARCREST DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404717",
            "telephone_number": "989-636-7580",
            "fax_number": "989-636-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "JOHN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004014",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "MI",
            "license": "4901004014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.