NPIMap

Individual provider Active NPI

Mejah Shireem Soong, MD

  • Psychiatry Physician
  • Manchester, NH
National Provider Identifier
1164646311
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
041648 Issued in CT
Practice address
100 McGregor St
Catholic Medical Center
Manchester, NH 03102
Phone
(603) 668-3545
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 041648 CT Primary

Addresses

Primary practice location

100 McGregor St
Catholic Medical Center
Manchester, NH 03102

Mailing address

405 Western Ave
#193
South Portland, ME 04106-1705
Phone (207) 521-4825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000160 WA Practitioner - Psychiatry 6204807589 Reassigns benefits to 1 organization
Practice locations: Port Townsend, WA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners in Well-Being, P.C., Inc.Group PAC ID 6507758810, 3 clinicians

Practice addresses (Care Compare)

281 A Lane de Chantal
Port Townsend, WA 98368-9671
Phone (360) 379-3500

281 Lane de Chantel
Port Townsend, WA 98368-9671

800 W Park Ave
Suite 4
Port Townsend, WA 98368-2283
Phone (360) 499-6750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
041648CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mejah Soong PLLC Psychiatry CurrentSince Jun 25, 2018 Accepting new patients
Natchaug Hospital, Inc. Past Accepting new patients
Sound Community Services, Inc. PastSince Apr 25, 2010 Accepting new patients
Urologic Associates, PC Past Accepting new patients
Viva, PLLC PastSince Jul 15, 2010 Accepting new patients

Locations

1136 Water St
Ste 107
Port Townsend, WA 98368
Phone (360) 385-4843

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

Organizations & group practices 6

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 3

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164646311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 WESTERN AVE",
            "address_2": "#193",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061705",
            "telephone_number": "207-521-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCGREGOR ST",
            "address_2": "CATHOLIC MEDICAL CENTER",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03102",
            "telephone_number": "603-668-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOONG",
        "first_name": "MEJAH",
        "middle_name": "SHIREEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "041648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.