Shane A Solberg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2334 Issued in WI

Practice address

S30W24896 Sunset Dr
Suite 105
Waukesha, WI 53189-7021

Phone

(262) 542-5295

Fax

(262) 542-5641

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

Yes

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 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

Illinois College of Optometry at Chicago, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Wisconsin LLCGroup PAC ID 5890033716, 27 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 and National Provider Directory roles.

• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • West Allis, WI
  • NPI 1710632864
  NPD
• Myeyedr Optometry of Wisconsin, LLC

  • Optometrist
  • Elm Grove, WI
  • NPI 1922610872
  NPD

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1285624080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S30W24896 SUNSET DR",
            "address_2": "SUITE 105",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531897021",
            "telephone_number": "262-542-5295",
            "fax_number": "262-542-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLBERG",
        "first_name": "SHANE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38587900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "391985642",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Sobrofski
• Eric Soderberg
• Anh Ngo Soemadi, PHARMD
• Solaris Recovery LLC
• Solberg Eye Care SC
• Solidarity Clinic LLC
• Solutions for Success, LLC
• Kaitlyn Solveson, APNP
• Patricia Marie Sombrio, RDH
• Rhonda Somers, APNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.