Scott H. Surdut, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTA 00356 Issued in RI

Practice address

1013 Reservoir Ave
Cranston, RI 02910-5134

Phone

(401) 942-4087

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• Sampalis Eyecare PC

  • Optometrist
  • Warwick, RI
  • NPI 1497016661
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1982780433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029105134",
            "telephone_number": "401-942-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 RESERVOIR AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029105134",
            "telephone_number": "401-942-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURDUT",
        "first_name": "SCOTT",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA 00356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX #",
            "identifier": "050381140",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Strate, OT
• Gus Gregory Stratton, M.D.
• Dana Stripling, PHARM.D.
• Jenevieve L Sullivan, M.S.
• Support Home Care LLC
• Elizabeth Sutton, OT
• Suzanne O'Shea Associates
• Andrew Swain, LCSW
• Maxine Swajian
• Barbara J Swanson, LICSW

• Optometrist in Cranston, RI
• Providers in Cranston, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.