Thomas W Samuelson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

30302 Issued in MN

Practice address

10709 Wayzata Blvd Ste 200
Minnetonka, MN 55305-5509

Phone

(952) 888-5800

Fax

(952) 567-6156

NPI assigned

Sep 19, 2005

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 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Minnesota Medical School, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Eye Consultants, PAGroup PAC ID 4284524539, 34 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.11 of 100Reported as group

Quality

73.53

Promoting interoperability

100

Improvement activities

40

Cost

60.18

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Minnesota Eye Consultants, PA

  • Ophthalmology Physician
  • Bloomington, MN
  • NPI 1508839879
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Hennepin Healthcare System, Inc

  • Rehabilitation Hospital Unit
  • Minneapolis, MN
  • NPI 1033138136
  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Hennepin Healthcare System Inc

  • Specialty Pharmacy
  • Minneapolis, MN
  • NPI 1619567625
  NPD
• Minnesota Retina Associates, LLC

  • Retina Specialist (Ophthalmology) Physician
  • Bloomington, MN
  • NPI 1356099352
  NPD

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1265427918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 DUPONT AVE S",
            "address_2": "SUITE 425",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313100",
            "telephone_number": "652-567-6092",
            "fax_number": "952-567-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10709 WAYZATA BLVD STE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553055509",
            "telephone_number": "952-888-5800",
            "fax_number": "952-567-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "30302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "851008300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31696600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Salo, MS, LADC, LPCC
• Ashaunte Marie Salone, RBT
• Renee Saltness
• Nirmal K Samanta, PHD, CCC-SLP
• Ali Riza Samikoglu, M.D.
• Berenice Abigail Sanchez-Ortiz, CF-SLP
• Gabriel M Sanchez, RN, NP-C
• Teresa Sanchez, NP
• Sanctuary Counseling & Consulting
• Katrina D Sanders, FNP-BC

• Ophthalmology Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.
• 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.