Individual provider Active NPI

Amy Michelle Soetaert, D.O.

  • Diagnostic Radiology Physician
  • Springfield, MO
National Provider Identifier
1093741290
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2008005527 Issued in MO
Practice address
2055 S Fremont Ave Ste 120
Springfield, MO 65804
Phone
(417) 820-2500
NPI assigned
Jun 23, 2006
Last updated
May 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2008005527 MO Primary

Addresses

Primary practice location

2055 S Fremont Ave Ste 120
Springfield, MO 65804

Mailing address

2055 S Fremont Ave Ste 120
Springfield, MO 65804-2206
Phone (417) 820-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090925000573 MO Practitioner - Diagnostic Radiology 1052467404 Reassigns benefits to 9 organizations
I20160316001413 SD Practitioner - Diagnostic Radiology 1052467404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Kansas City University of Physicians and Surgeons, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SpringfieldGroup PAC ID 7416867593, 54 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2115

2055 S Fremont Ave
120 MC Breast Center
Springfield, MO 65804-2206
Phone (417) 820-2395

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Carthage CurrentSince Jan 1, 2025 Accepting new patients
Mercy Hospital Springfield CurrentSince Jul 4, 2018 Accepting new patients
Mercy Hospital Springfield CurrentSince Jul 4, 2018 Accepting new patients
Mercy Hospital Cassville CurrentSince Jan 1, 2025 Accepting new patients
Mercy Clinic Joplin LLC CurrentSince Jan 1, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jun 1, 2018 Accepting new patients
Mercy Hospital Cassville CurrentSince Jan 1, 2025 Accepting new patients
Mercy Hospital Aurora CurrentSince Jan 1, 2025 Accepting new patients
Sanford Clinic Diagnostic Radiology CurrentSince Feb 22, 2016 Accepting new patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Feb 22, 2016 Accepting new patients
Mercy Hospital Aurora CurrentSince Jan 1, 2025 Accepting new patients
Mercy Hospital Carthage CurrentSince Jan 1, 2025 Accepting new patients
Slci Physician Services, LLC Diagnostic Radiology Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jun 1, 2018 Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

3116 Medical Park Dr
Carthage, MO 64836
Phone (417) 358-7574

3125 Dr Russell Smith Way
Carthage, MO 64836
Phone (417) 358-8121

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

4321 Washington St
Ste 1000
Kansas City, MO 64111
Phone (816) 932-2307

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2055 S Fremont Ave
Ste 120
Springfield, MO 65804
Phone (417) 820-2395

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1210 W 18th St
Ste LL03
Sioux Falls, SD 57104
Phone (605) 328-1410

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 9

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1093741290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE STE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042206",
            "telephone_number": "417-820-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 S FREMONT AVE STE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-820-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOETAERT",
        "first_name": "AMY",
        "middle_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2008005527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.