Samuelson Eyecare LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SAMUELSON EYECARE LLC

Practice address

428 West Main St
Mount Horeb, WI 53572-2103

Phone

(608) 437-3377

Fax

(608) 437-5063

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Lauren Ta-Samuelson, OD

Title

Optometrist

Phone

(608) 437-3377

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Samuelson, OD

  • Optometrist
  • Mount Horeb, WI
  • NPI 1275519290
  Medicare reassignment Care Compare group NPD
• Lauren Ta, OD

  • Optometrist
  • Mount Horeb, WI
  • NPI 1811973605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1710072939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 WEST MAIN ST",
            "address_2": "PO BOX 350",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535722103",
            "telephone_number": "608-437-3377",
            "fax_number": "608-437-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 WEST MAIN ST",
            "city": "MOUNT HOREB",
            "state": "WI",
            "postal_code": "535722103",
            "telephone_number": "608-437-3377",
            "fax_number": "608-437-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUELSON EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "TA-SAMUELSON",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "608-437-3377",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38714000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Elizabeth Rott, RN
• Alexander Adam Ruchti
• Lyndsay Rupnow, COTA
• Joseph William Ryan, DOCTOR OF CHIROPRACT
• William Steven Salinger, DC
• Steven Samuelson, OD
• Elise Scharenbroch, RN
• Susan Carol Schaut, LPN,RCS
• Brenda J Schmitt, FNP
• Elisa Schoeberle, SLP

• Optometrist in Mount Horeb, WI
• Providers in Mount Horeb, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.