Michael Soltysiak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OE-007231T Issued in PA

Practice address

564 Union St
Luzerne, PA 18709-1245

Phone

(570) 288-3336

Fax

(570) 283-2682

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487727830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 UNION ST",
            "city": "LUZERNE",
            "state": "PA",
            "postal_code": "187091245",
            "telephone_number": "570-288-3336",
            "fax_number": "570-283-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 UNION ST",
            "city": "LUZERNE",
            "state": "PA",
            "postal_code": "187091245",
            "telephone_number": "570-288-3336",
            "fax_number": "570-283-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLTYSIAK",
        "first_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE-007231T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "799765",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Luzerne, PA
• Providers in Luzerne, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.