NPIMap

Individual provider Active NPI

Cheng-Lun Soo, MD

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
National Provider Identifier
1013912617
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
21124 Issued in OK
Practice address
13700 S Western Ave Ste 100
Oklahoma City, OK 73170-7006
Phone
(405) 631-4263
Fax
(405) 982-1583
NPI assigned
Jun 20, 2005
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 21124 OK Primary
Interventional Pain Medicine Physician 208VP0014X 21124 OK

Addresses

Primary practice location

13700 S Western Ave Ste 100
Oklahoma City, OK 73170-7006

Mailing address

13700 S Western Ave Ste 100
Oklahoma City, OK 73170-7006
Phone (405) 806-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100813000246 OK Practitioner - Orthopedic SurgeryPractitioner - Pain Management 0648228221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pain Management
Education
University of Kentucky College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13700 S Western Ave
Suite 100
Oklahoma City, OK 73170-7006
Phone (405) 806-7246

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion18
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Center for Spine & Pain Solutions PC Orthopaedic Surgery of the Spine CurrentSince Jan 2, 2018 Accepting new patients
Jackson County Memorial Hospital Authority Interventional Pain Medicine Past Accepting new patients
Summit Medical Center Interventional Pain Medicine Past Accepting new patients

Locations

13700 S Western Ave
Ste 100
Oklahoma City, OK 73170
Phone (405) 669-3569

9821 S May Ave
Ste B
Oklahoma City, OK 73159
Phone (405) 631-4263

Interoperability endpoints

  • Direct secure messaging: csoo@direct.uspi.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ADFCBD/Endpoint/ADFCBD

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1013912617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 S WESTERN AVE STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707006",
            "telephone_number": "405-806-7246",
            "fax_number": "405-616-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 S WESTERN AVE STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731707006",
            "telephone_number": "405-631-4263",
            "fax_number": "405-982-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOO",
        "first_name": "CHENG-LUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OK",
            "license": "21124",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "OK",
            "license": "21124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.