Robert A Kominiarek, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34006547 Issued in OH

Practice address

450 B Washington Jackson Rd
Suite 106
Eaton, OH 45320

Phone

(937) 456-8370

Fax

(937) 456-8371

NPI assigned

Oct 12, 2006

Last updated

Sep 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert a Kominiarek DO Inc

  dba Preble County Family Pracitce

  • Family Medicine Physician
  • Eaton, OH
  • NPI 1639386089
  Authorized official Same address or phone
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1841389913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 305",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453200305",
            "telephone_number": "937-456-8370",
            "fax_number": "937-456-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 B WASHINGTON JACKSON RD",
            "address_2": "SUITE 106",
            "city": "EATON",
            "state": "OH",
            "postal_code": "45320",
            "telephone_number": "937-456-8370",
            "fax_number": "937-456-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMINIAREK",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34006547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065572",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "431957177",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kesla B Klingler
• Brenna Kluesener
• Elizabeth Kniesly
• Thomas J Knobbe, PH.D.
• Christina Lin Koehl, COTA/L
• Kroger Limited Partnership I (Kroger Pharmacy #808)
• Cynthia Jo Kyle, RN, CHPN
• L&M Products, Inc.
• Lisa Marie Landerer, CPRSS
• Walter Carlos Landerer III

• Family Medicine Physician in Eaton, OH
• Providers in Eaton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.