Individual provider Active NPI

Solomon M Gould, OD

  • Optometrist
  • Saint Paul, MN
National Provider Identifier
1518232149
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3415 Issued in MN
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

Updated by the provider on Apr 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
030-0086043OtherVTVERMONT LICENSE
1518232149OtherMNNPI TYE I
3415OtherMNMN 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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3415MNMDProfessional Counselor
0000000VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Lake Family Eye Care Inc. Optometrist Current Accepting new patients
Calvin Optometry PLLC Optometrist PastSince Apr 17, 2018 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.

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.

Verify at the official NPI Registry.