Samuel K Soda, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3930 Issued in WI

Practice address

1442 N 31St St
Sheboygan, WI 53081-3061

Phone

(920) 452-5400

NPI assigned

Apr 14, 2023

Last updated

Aug 13, 2025By the provider in NPPES

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 WI

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

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Larson Eye Care SCGroup PAC ID 8022098409, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Larson Eye Care SC

  • Ophthalmology Physician
  • Sheboygan, WI
  • NPI 1629039961
  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment
• Gundersen Clinic, LTD.

  • Clinic/Center
  • Prairie Du Chien, WI
  • NPI 1972554590
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Gundersen Lutheran Medical Center, Inc.

  dba Emplify Health La Crosse Hospital DME

  • Durable Medical Equipment & Medical Supplies
  • La Crosse, WI
  • NPI 1447478607
  NPD

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1194411850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-452-5400",
            "fax_number": "920-452-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 N 31ST ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813061",
            "telephone_number": "920-452-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODA",
        "first_name": "SAMUEL",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-14",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "119996",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Lawrence Smith, D.O.
• Mackenzie Mae Smith
• Rachel E Smith, DC
• Sarah Jeane Smith, M.D.
• Beth Sobczak III, PT
• Ekaterina V Soforo, M.D.
• Raymond Seth Sohn, D.O
• Rana P Sokhi, MD
• Solidaritus Health Wisconsin SC
• Christina Somerville

• Optometrist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.