Yong Soo So, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

YS037124 Issued in MI

Practice address

22001 Kelly Rd
Eastpointe, MI 48021-2708

Phone

(586) 778-0209

NPI assigned

Sep 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

General Practice

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Yong Soo So, M.D., P.C.

  • General Practice Physician
  • Eastpointe, MI
  • NPI 1356405294
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190505600000",
    "number": "1073708046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212708",
            "telephone_number": "586-778-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212708",
            "telephone_number": "586-778-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "YONG",
        "middle_name": "SOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "YS037124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4641238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Shinta Smith
• Kayla Smith
• Michele Smith
• Paris Nelson Smith
• Robin Smith
• Edwin Jose Soler-Valcourt, M.D.
• Solid Care Health Services, LLC
• Mark Solway, D.D.S
• Son - Lu Home Care Doctors PC
• Special Touch Learning Center, Inc.,

• General Practice Physician in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2007; 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.