Individual provider Active NPI

Michael Stephen Somero, MD

  • Internal Medicine Physician
  • Miami Beach, FL
National Provider Identifier
1083690796
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME116417 Issued in FL
Practice address
4308 Alton Rd
Suite 950/960
Miami Beach, FL 33140-3316
Phone
(305) 538-1400
Fax
(305) 538-6102
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME116417 FL Primary
Internal Medicine Physician 207R00000X G77068 CA

Addresses

Primary practice location

4308 Alton Rd
Suite 950/960
Miami Beach, FL 33140-3316

Mailing address

8390 Champions Gate Blvd
Suite 215
Champions Gate, FL 33896-8310
Phone (407) 390-1677

Other identifiers 3

IdentifierTypeStateIssuer
012236200MedicaidFL
1508026725MedicaidCA
440002198OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171010001819 MI Practitioner - Infectious Disease 0941369417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

19251 Mack Ave
Suite 333
Grosse Pointe Woods, MI 48236-2898
Phone (313) 343-7280

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME116417FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Sep 1, 2019 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Henry Ford Health St. John Hospital Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
W.a. Foote Memorial Hospital, Inc. Infectious Disease CurrentSince Sep 3, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 3, 2017 Accepting new patients
St. John Hospital Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280

22201 Moross Rd
Ste 50
Grosse Pointe Woods, MI 48236
Phone (313) 343-7774

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

2200 Springport Rd
Ste 240
Jackson, MI 49202
Phone (517) 205-2107

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

Interoperability endpoints

  • Direct secure messaging: msomero495524@direct.hfhs.org

Organizations & group practices 8

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 1

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1083690796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "SUITE 215",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968310",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 ALTON RD",
            "address_2": "SUITE 950/960",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403316",
            "telephone_number": "305-538-1400",
            "fax_number": "305-538-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERO",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME116417",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G77068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012236200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508026725",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "440002198",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.