NPIMap

Individual provider Active NPI

Beau Bradley Sorenson, PA

  • Physician Assistant
  • Cedar Falls, IA
National Provider Identifier
1023727757
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
118465 Issued in IA
Practice address
4612 Prairie Pkwy
Cedar Falls, IA 50613-7971
Phone
(319) 859-8139
NPI assigned
Nov 21, 2022
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 118465 IA Primary
Surgical Physician Assistant 363AS0400X 118465 IA

Addresses

Primary practice location

4612 Prairie Pkwy
Cedar Falls, IA 50613-7971

Mailing address

PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230207000856 IA Practitioner - Physician Assistant 0446622179 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

112 Jefferson St
West Union, IA 52175-1022
Phone (319) 833-5935

1600 1St St E
Independence, IA 50644-3155
Phone (319) 334-6071

1753 W Ridgeway Ave
Waterloo, IA 50701-4588

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3941

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 833-5954

4612 Prairie Pkwy
Cedar Falls, IA 50613-7971
Phone (319) 859-8139

502 N 9TH Ave
Vinton, IA 52349-2254
Phone (319) 833-5922

505 S 1St Ave E
Lake Mills, IA 50450-1425
Phone (641) 592-3900

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Cedar Valley Medical Specialists PC CurrentSince Feb 6, 2023 Accepting new patients
Cedar Valley Medical Specialists PC CurrentSince Feb 6, 2023 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients

Locations

1600 1st St E
Independence, IA 50644
Phone (319) 332-0999

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

Interoperability endpoints

  • Direct secure messaging: beau.sorenson@cvms.eclinicaldirectplus.com
  • Direct secure messaging: bsorenson678987@direct.unitypoint.org
  • Direct secure messaging: bsorenson815037@direct.emplifyhealth.org

Organizations & group practices 9

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 5

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1023727757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 PRAIRIE PKWY",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506137971",
            "telephone_number": "319-859-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "BEAU",
        "middle_name": "BRADLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "118465",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "118465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Falls, IA

Sources for this page

Verify at the official NPI Registry.