NPIMap

Soderstrom Dermatology Center S C

A Medicare group practice based in Peoria, IL: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 2062432651), with 52 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
2062432651The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Ambulatory Surgical Center, Part B Supplier - Clinic/Group Practice
Enrolled in
IA, IL
Enrollments
3
Group size
31 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
15In 14 places

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20051128000693 IL Part B Supplier - Clinic/Group Practice 1710931670
O20080104000600 IA Part B Supplier - Clinic/Group Practice 1710931670
O20120111000387 IL Part B Supplier - Ambulatory Surgical Center 1053362343

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Merit-based Incentive Payment System (MIPS)

Medicare Care Compare
Final score
75 of 100Reported as group, on the record of 18 clinicians in this group

Clinicians 52

Clinicians who reassign their Medicare benefits to this group (52) or whom Care Compare lists as members (31).

Sources for this page