Individual provider Active NPI

Theresa Solaski Daus, OD

  • Optometrist
  • West Islip, NY
National Provider Identifier
1770587727
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005592 Issued in NY
Practice address
360 Montauk Hwy
West Islip, NY 11795-4403
Phone
(631) 422-1110
NPI assigned
Jun 8, 2005
Last updated
Feb 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 005592 NY Primary
Optometrist 152W00000X TA1461 MD
Optometrist 152W00000X 0618002137 VA

Addresses

Primary practice location

360 Montauk Hwy
West Islip, NY 11795-4403

Mailing address

360 Montauk Hwy
West Islip, NY 11795-4403
Phone (631) 422-1110

Other identifiers 3

IdentifierTypeStateIssuer
8185-0004OtherDCCAREFIRST
10036579OtherMDMEDICARE RR PIN
54725501OtherMDCAREFIRST

Other names 1

  • Theresa Jean Solaski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201123001880 DC Practitioner - Optometry 7618016692 Reassigns benefits to 1 organization
I20221223000807 NY Practitioner - Optometry 7618016692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005592NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina Braun, M.D., P.C. CurrentSince Oct 19, 2020 Accepting new patients
Medical Surgical Eye Care Services PC CurrentSince Jan 25, 2023 Accepting new patients
Frederick J Sauerburger MD PA Optometrist CurrentSince Nov 24, 1997 Accepting new patients
Medical Surgical Eye Care Services, PC Optometrist PastSince Jan 25, 2023 Accepting new patients

Locations

11345 Pembrooke Sq
Ste 105
Waldorf, MD 20603
Phone (301) 645-8120

360 Montauk Hwy
West Islip, NY 11795
Phone (631) 422-1110

8101 Hinson Farm Rd
Ste 103
Alexandria, VA 22306
Phone (703) 360-0111

Interoperability endpoints

  • Direct secure messaging: tdaus@tceco.intellechartdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1770587727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUS",
        "first_name": "THERESA",
        "middle_name": "SOLASKI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005592",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1461",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002137",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "8185-0004",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PIN",
            "identifier": "10036579",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "54725501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "SOLASKI",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.