Gabriel Sotomayor, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036170227 Issued in IL

Practice address

1802 S Mattis Ave
Champaign, IL 61821-5923

Phone

(217) 902-6954

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and Rehabilitation

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• Kirby Medical Center Hospital, Monticello, IL, CCN 141301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gsotomayormd418833@carlehiedirect.net

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.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Kirby Medical Center

  dba Kirby Ambulance

  • Land Ambulance
  • Monticello, IL
  • NPI 1598869133

  Hospital

  Care Compare affiliation
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847
  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1013470061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61802",
            "telephone_number": "217-902-6954",
            "fax_number": "217-902-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 S MATTIS AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215923",
            "telephone_number": "217-902-6954"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8701 Watertown Plank Road",
            "address_2": "MCWAH Transitional Year Program",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53226",
            "country_code": "US",
            "telephone_number": "414-955-4578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTOMAYOR",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036170227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seokjae Son, D.M.D
• Keychun Song, LAC
• Myoungsu Song
• Soeyun Song, LAC
• Pamela Kae Soper, L.C.S.W
• Soul Counseling, PLLC
• Dancia Southerland
• Jenna Sowinski
• Marta T Spain, MD
• Paige Stephanie Spangler, LPC

• Physical Medicine & Rehabilitation Physician in Champaign, IL
• Providers in Champaign, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.