Robert Thomas Kocembo Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003828A Issued in IN

Practice address

40566 Alden Rd
Belleville, MI 48111-2852

Phone

(313) 719-8967

Fax

(313) 259-6006

NPI assigned

Jul 1, 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

Medicare fee-for-service enrollment

Enrolled in MI, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkocembo020673@myeyedr.emadirect.md

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.

• Heritage Optical Center Inc

  • Optometrist
  • Detroit, MI
  • NPI 1285728964

  MI, Optometrist

  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596

  MI, Optometrist

  Medicare reassignment NPD
• Onsight, Inc.

  • Podiatrist
  • East Lansing, MI
  • NPI 1821248568

  MI

  Medicare reassignment NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424

  IN, Optometrist

  Medicare reassignment NPD
• Onhealthcare, LLC

  • Optometrist
  • Indianapolis, IN
  • NPI 1417220369

  IN, Optometrist

  Medicare reassignment NPD
• West Point Optical Group

  • Optometrist
  • Novi, MI
  • NPI 1831548890

  MI

  Medicare reassignment
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Clarkston, MI
  • NPI 1215753553
  NPD
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Sturgis, MI
  • NPI 1730764267
  NPD
• Onsight, Inc.

  • Dentist
  • East Lansing, MI
  • NPI 1730339474
  NPD
• Onsight, Inc.

  • Optometrist
  • East Lansing, MI
  • NPI 1831356807
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Elkhart, IN
  • NPI 1427633999
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1730118878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40566 ALDEN RD",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112852",
            "telephone_number": "313-719-8967",
            "fax_number": "313-259-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40566 ALDEN RD",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481112852",
            "telephone_number": "313-719-8967",
            "fax_number": "313-259-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 W North St",
            "address_purpose": "LOCATION",
            "city": "Kendallville",
            "state": "IN",
            "postal_code": "467551134",
            "country_code": "US",
            "telephone_number": "260-349-1008",
            "fax_number": "260-349-0549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCEMBO",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "MI4901003146",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003828A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Belleville, MI
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.