Kalamazoo Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002237 Issued in MI

Legal business name

KALAMAZOO OPTOMETRY PC

Practice address

5949 Lovers LN
Portage, MI 49002-1680

Phone

(269) 382-6500

Fax

(269) 382-2286

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Stacy Hiemstra

Title

Office Manager

Phone

(269) 382-6500

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Luigi Greco, O.D.

  • Optometrist
  • Portage, MI
  • NPI 1295101889
  Medicare reassignment Care Compare group NPD
• Katie Lynne Sutter, OD

  • Pediatric Optometrist
  • Portage, MI
  • NPI 1043651128
  Medicare reassignment Care Compare group NPD
• Marie Louise Fox, O.D.

  • Optometrist
  • Portage, MI
  • NPI 1790773646
  NPD (past)
• Carla Gilbertson Kuiken, O.D.

  • Optometrist
  • Battle Creek, MI
  • NPI 1992083968
  NPD (past)
• Andrew R Anderson, OD

  • Optometrist
  • Mishawaka, IN
  • NPI 1104854942
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1417148669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5949 LOVERS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021680",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5949 LOVERS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021680",
            "telephone_number": "269-382-6500",
            "fax_number": "269-382-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMAZOO OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "HIEMSTRA",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-382-6500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002440",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004197",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002237",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945006007",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900C947460",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945031190",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944536386",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945006016",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalamazoo Endo Center LLC
• Kalamazoo Foot and Ankle Specialists, PLC
• Kalamazoo Nerve Center, PLLC
• Kalamazoo Neurofeedback and Counseling Center (Insight Research Services)
• Kalamazoo Ophthalmology PC
• Kalamazoo Oral & Maxillofacial Surgery, P.C.
• Kalamazoo Valley Counseling and Therapy Supports
• Megan A Kamerman, LLMSW
• Michelle Kaminski
• Chethana Kanaparthi, M.D.

• Optometrist in Portage, MI
• Providers in Portage, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.