Daniel Thomas Soderberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.006093 Issued in OH

Practice address

1164 Lexington Ave
Mansfield, OH 44907-2254

Phone

(419) 756-0500

NPI assigned

Jul 6, 2011

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 OH

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

Ohio State University - College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Ronald J Gaudio and Associates IncGroup PAC ID 2062301278, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daniel.soderberg.1@16701.direct.athenahealth.com

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.

• Dr Ronald J Gaudio & Associates Inc

  • Optometrist
  • Delaware, OH
  • NPI 1447286034
  Medicare reassignment Care Compare group NPD
• 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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1245527654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WOODLAND HALL DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430157009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072254",
            "telephone_number": "419-756-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERBERG",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002472",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.006093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Snoring Sleep Apnea and Advanced Sleep Appliance Management LLC
• Hollie Ann Snow, SLP
• Cara E Snyder, MSW/LISW
• Kierston Nicole Snyder
• Laura Snyder
• Solace Pain Consultants LLC
• Deana Shaikh Solaiman
• Stephane Solinger
• Amanda Soliven, LPCC
• Diane Lynn Soltesz, LISW

• Optometrist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.