Joel Sollom, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3059 Issued in MN

Practice address

16105 Cedar Ave
Lakeville, MN 55044-7213

Phone

(952) 985-6467

Fax

(952) 985-6468

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Struss Optical, Inc.

  • Optometrist
  • Red Wing, MN
  • NPI 1821125535
  Medicare reassignment
• Vision World Inc

  • Eyewear Supplier
  • Stillwater, MN
  • NPI 1740365642
  NPD (past)
• Vision World Inc

  • Eyewear Supplier
  • Fergus Falls, MN
  • NPI 1982789533
  NPD (past)
• Visionworks, Inc.

  • Optometrist
  • Austin, MN
  • NPI 1881962173
  NPD (past)
• River Falls Eye Surgery and Laser Center Inc.

  • Specialist
  • River Falls, WI
  • NPI 1437253077
  NPD (past)
• Visionworks Inc

  • Eyewear Supplier
  • Omaha, NE
  • NPI 1205924792
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1174546923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447213",
            "telephone_number": "952-985-6467",
            "fax_number": "952-985-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLOM",
        "first_name": "JOEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "669152000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Snyders Drug
• Ashlee Alyssa Achtenberg Soberg, MA, BCBA
• Hira Sohail, DDS
• Teresa A Solberg Moore, MA LMFT
• Andrea Katrina Soles, LMFT
• Abigail Somerville
• Melissa Catherine Gabbert Soukup, PHARM. D.
• Steven John Soukup
• Soul Solace Massage LLC
• South Metro Care Services

• Optometrist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.