MEDICARE: DR. JONATHAN TOSO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	570	SD
2	152W00000X	Optometrist	2042	IA
3	152W00000X	Optometrist	2459	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U44402	OTHER	MN	UPIN
2	0040062	OTHER	SD	WELLMARK BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154381770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN TOSO O.D.

Provider Business Mailing Address
First Line	:	109 E 5TH ST
Second Line	:	BOX 39
City	:	CANTON
State	:	SD
Zip	:	57013-1731
Country	:	US
Telephone Number	:	605-987-2841
Fax Number	:	605-987-2810

Provider Business Practice Location Address
First Line	:	109 E 5TH ST
Second Line	:	BOX 39
City	:	CANTON
State	:	SD
Zip	:	57013-1731
Country	:	US
Telephone Number	:	605-987-2841
Fax Number	:	605-987-2810

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	11/20/2025

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