Kalamazoo Ophthalmology PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

KALAMAZOO OPHTHALMOLOGY PC

Practice address

3412 W Centre Ave
Portage, MI 49024-4624

Phone

(269) 329-5860

Fax

(269) 329-5865

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Stephen E Higgins, M.D.NPI 1235104845

Title

Owner

Phone

(269) 329-5860

Specialties & licenses 2

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: agoodman@kopc.intellechartdirect.net

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory C Bibart, MD

  • Ophthalmology Physician
  • Portage, MI
  • NPI 1871568485
  Medicare reassignment Care Compare group NPD
• Lynnette Raye Blostica, O.D.

  • Optometrist
  • Portage, MI
  • NPI 1053524884
  Medicare reassignment Care Compare group NPD
• Ariel Lynne Goodman, OD

  • Optometrist
  • Portage, MI
  • NPI 1790424067
  Medicare reassignment Care Compare group NPD
• Stephen E Higgins, MD

  • Ophthalmology Physician
  • Portage, MI
  • NPI 1235104845
  Medicare reassignment NPD Authorized official
• Ferris R Standiford, O.D.

  • Optometrist
  • Portage, MI
  • NPI 1164485801
  Medicare reassignment Care Compare group NPD
• Liesel Zima, MD

  • Ophthalmology Physician
  • Portage, MI
  • NPI 1316352024
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1467475723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244624",
            "telephone_number": "269-329-5860",
            "fax_number": "269-329-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244624",
            "telephone_number": "269-329-5860",
            "fax_number": "269-329-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMAZOO OPHTHALMOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-329-5860",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "180C960320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FERRIS STANDIFORD",
            "identifier": "FS003034",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREGORY BIBART",
            "identifier": "1863900012",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FERRIS STANDIFORD",
            "identifier": "900C965580",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREGORY BIBART",
            "identifier": "GB072121",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREGORY BIBART",
            "identifier": "1803906051",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STEPHEN HIGGINS",
            "identifier": "SH405954",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2669516",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "180C910010",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4415148",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STEPHEN HIGGINS",
            "identifier": "1803901811",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4073524",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Megan A Kamerman, LLMSW
• Michelle Kaminski

• Ophthalmology Physician in Portage, MI
• Providers in Portage, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.