Individual provider Active NPI

Donald J Soderquist, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Torrington, CT
National Provider Identifier
1093592131
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12351 Issued in CT
Practice address
58 High St
Torrington, CT 06790-5106
Phone
(860) 496-2100
NPI assigned
Sep 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 12351 CT Primary

Addresses

Primary practice location

58 High St
Torrington, CT 06790-5106

Mailing address

58 High St
Torrington, CT 06790-5106
Phone (860) 496-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20231023001867 CT Practitioner - Nurse Practitioner 3375999659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McCall Foundation, Inc.Group PAC ID 0345417929, 12 clinicians

Practice addresses (Care Compare)

58 High St
Torrington, CT 06790-5106
Phone (860) 496-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12351CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McCall Foundation Inc. CurrentSince Sep 18, 2023 Accepting new patients
McCall Foundation, Inc. CurrentSince Sep 18, 2023 Accepting new patients
McCall Foundation, Inc. Current Accepting new patients

Locations

58 High St
Torrington, CT 06790
Phone (860) 496-2107

Interoperability endpoints

  • Direct secure messaging: donald.soderquist.p1@direct.mccallbhn.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1093592131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 HIGH ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067905106",
            "telephone_number": "860-496-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 HIGH ST",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067905106",
            "telephone_number": "860-496-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERQUIST",
        "first_name": "DONALD",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

Verify at the official NPI Registry.