Individual provider Active NPI

Ruth M Soderberg, NP

  • Pediatrics Physician
  • Taunton, MA
National Provider Identifier
1043257637
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
124419NP Issued in MA
Practice address
2007 Bay St
Ste 103
Taunton, MA 02780-1086
Phone
(508) 880-7858
Fax
(508) 822-5972
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 124419NP MA Primary
Adult Health Nurse Practitioner 363LA2200X 124419 MA

Addresses

Primary practice location

2007 Bay St
Ste 103
Taunton, MA 02780-1086

Mailing address

2007 Bay St
Ste 103
Taunton, MA 02780-1086
Phone (508) 880-7858

Other identifiers 1

IdentifierTypeStateIssuer
0318116MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060124000591 MA Practitioner - Nurse Practitioner 3577587997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Management LLPGroup PAC ID 7214974708, 18 clinicians

Practice addresses (Care Compare)

105 Webster St
Suite 8
Hanover, MA 02339-1227
Phone (781) 754-6545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
124419NPMAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Management, LLP CurrentSince Dec 6, 1999 Accepting new patients
Golden Insight Inc CurrentSince Apr 25, 2021 Accepting new patients
Morton Physician Associates Inc Adult Health Past Accepting new patients
Child and Family Psychological Services, PLLC Past Accepting new patients
Pediatric Associates at Northwoods Pediatrics Past Accepting new patients

Locations

105 Webster St
Ste 8
Hanover, MA 02339
Phone (781) 312-7457

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1043257637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 BAY ST",
            "address_2": "STE 103",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027801086",
            "telephone_number": "508-880-7858",
            "fax_number": "508-822-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 BAY ST",
            "address_2": "STE 103",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027801086",
            "telephone_number": "508-880-7858",
            "fax_number": "508-822-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERBERG",
        "first_name": "RUTH",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "124419NP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "124419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0318116",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taunton, MA

Sources for this page

Verify at the official NPI Registry.