Active NPI
Solomon M Gould, OD
- Optometrist
- Saint Paul, MN
National Provider Identifier
1518232149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3415
- Practice address
- 1995 Burns Ave Ste B
Saint Paul, MN 55119-4906 - Phone
- (651) 739-5173
- Fax
- (651) 739-8907
- NPI assigned
- Mar 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0000000 | VT | |
| Optometrist | 152W00000X | 3415 | MN | Primary |
Addresses
Primary practice location
1995 Burns Ave Ste B
Saint Paul, MN 55119-4906
Mailing address
1995 Burns Ave Ste B
Saint Paul, MN 55119-4906
Phone (651) 739-5173
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030-0086043 | Other | VT | VERMONT LICENSE |
| 1518232149 | Other | MN | NPI TYE I |
| 3415 | Other | MN | MN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3415 | MN | MD | Professional Counselor |
| 0000000 | VT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Lake Family Eye Care Inc. | Optometrist | Current | Accepting new patients |
| Calvin Optometry PLLC | Optometrist | Past | Accepting new patients |
| Gould Eye Care LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Optometrist
- Inver Grove Heights, MN
- NPI 1639504129
-
- Optometrist
- Maple Grove, MN
- NPI 1962762039
-
- Optometrist
- Saint Paul, MN
- NPI 1982769501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523318400000",
"number": "1518232149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1995 BURNS AVE STE B",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551194906",
"telephone_number": "651-739-5173",
"fax_number": "651-739-8907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1995 BURNS AVE STE B",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551194906",
"telephone_number": "651-739-5173",
"fax_number": "651-739-8907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULD",
"first_name": "SOLOMON",
"middle_name": "M",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-15",
"last_updated": "2018-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VT",
"license": "0000000",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VERMONT LICENSE",
"identifier": "030-0086043",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI TYE I",
"identifier": "1518232149",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN LICENSE",
"identifier": "3415",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.