NPIMap

Individual provider Active NPI

Damon R Soeiro, MD

  • Diagnostic Radiology Physician
  • Upland, PA
National Provider Identifier
1023097250
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD428474 Issued in PA
Practice address
1 Medical Center Blvd
Crozer-Chester Medical Center; Dept. Radiology
Upland, PA 19013-3902
Phone
(610) 447-2595
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 223821 MA
Diagnostic Radiology Physician 2085R0202X MD428474 PA Primary

Addresses

Primary practice location

1 Medical Center Blvd
Crozer-Chester Medical Center; Dept. Radiology
Upland, PA 19013-3902

Mailing address

1 Medical Center Blvd
Crozer-Chester Medical Center; Dept. of Radiology
Upland, PA 19013-3902
Phone (610) 447-2595

Other identifiers 1

IdentifierTypeStateIssuer
2103478MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061020000058 PA Practitioner - Diagnostic Radiology 8123064938 Reassigns benefits to 2 organizations
I20241209001409 NJ Practitioner - Diagnostic Radiology 8123064938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Physician Assoc IncGroup PAC ID 1355243809, 164 clinicians

Practice addresses (Care Compare)

102 S Swarthmore Ave
Swarthmore, PA 19081-1603
Phone (800) 475-6112

185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone (908) 859-6700

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
  • St Luke'S Hospital - Grand View Campus Hospital, Sellersville, PA, CCN 390057
  • St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330
  • St Luke'S Hospital - Carbon Campus Hospital, Lehighton, PA, CCN 390335
  • St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223821MAMDDiagnostic Radiology Physician
MD428474PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physician Assoc Inc Diagnostic Radiology CurrentSince Jul 29, 2024 Accepting new patients
Southeast Radiology LTD Diagnostic Radiology CurrentSince Jul 1, 2006 Accepting new patients
Massachusetts General Physicians Organization Inc Diagnostic Radiology Past Accepting new patients

Locations

185 Roseberry St
Phillipsburg, NJ 08865
Phone (908) 213-6611

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

300 Evergreen Dr
Ste 210
Glen Mills, PA 19342
Phone (610) 566-9400

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1023097250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "CROZER-CHESTER MEDICAL CENTER; DEPT. OF RADIOLOGY",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "CROZER-CHESTER MEDICAL CENTER; DEPT. RADIOLOGY",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-447-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOEIRO",
        "first_name": "DAMON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "223821",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD428474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103478",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, PA

Sources for this page

Verify at the official NPI Registry.