Individual provider Active NPI

Matthew Kaminsky, O.D.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1851709091
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003115 Issued in CO
Practice address
1075 N Academy Blvd
Colorado Springs, CO 80909-4401
Phone
(719) 597-4001
Fax
(719) 597-4110
NPI assigned
Jul 31, 2014
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OA00655100 NJ
Optometrist 152W00000X OPT.0003115 CO Primary

Addresses

Primary practice location

1075 N Academy Blvd
Colorado Springs, CO 80909-4401

Mailing address

1075 N Academy Blvd
Colorado Springs, CO 80909-4401
Phone (719) 597-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20190321001368 CO Practitioner - Optometry 6507106986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00655100NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
James Lee MD PC CurrentSince Mar 18, 2019 Accepting new patients
Eye Love Care Inc Optometrist Past Accepting new patients
America's Best Contacts & Eyeglasses Past Accepting new patients
Eye Love Care Inc Optometrist Past Accepting new patients

Locations

9320 Grand Cordera Pkwy
#25
Colorado Springs, CO 80924
Phone (719) 258-1240

9320 Grand Cordera Pkwy
Ste 255
Colorado Springs, CO 80924
Phone (719) 258-1240

23500 US Highway 160
Walsenburg, CO 81089
Phone (719) 738-5100

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1851709091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094401",
            "telephone_number": "719-597-4001",
            "fax_number": "719-597-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094401",
            "telephone_number": "719-597-4001",
            "fax_number": "719-597-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00655100",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.