Brent L Soder, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD187291 Issued in OR

Practice address

2801 NW Mercy Dr Ste 330
Roseburg, OR 97471-2348

Phone

(541) 677-3600

Fax

(541) 677-3601

NPI assigned

May 16, 2012

Last updated

May 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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 Surgery

Education

Medical University of South Carolina College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Merit-based Incentive Payment System (MIPS)

Final score

83.4 of 100Reported as group

Quality

67.01

Promoting interoperability

99

Improvement activities

40

Cost

78.48

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centennial Medical Group Inc.

  • Surgery Physician
  • Roseburg, OR
  • NPI 1518103274
  Medicare reassignment Care Compare group NPD
• Centennial Medical Group Inc.

  dba Centennial Shaw Heart & Vascular Specialists

  • Cardiovascular Disease Physician
  • Roseburg, OR
  • NPI 1033365135
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  dba CHI Mercy Medical Center

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1164782728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NW MERCY DR STE 330",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712348",
            "telephone_number": "541-677-3600",
            "fax_number": "541-677-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NW MERCY DR STE 330",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712348",
            "telephone_number": "541-677-3600",
            "fax_number": "541-677-3601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 E 3rd St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374032138",
            "country_code": "US",
            "telephone_number": "423-778-7695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SODER",
        "first_name": "BRENT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-16",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD187291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Smith, RN
• Scott Christian Smith, M.D.
• Vickie Laverne Smith, OTR/L
• David Snawder
• Cindy Snelling
• David Kent Soder, DDS
• Eric A Soder, MD
• Carmela Rosa Solimine
• Adam Solomon, NURSE PRACTITIONER
• Agatha Song

• Surgery Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; 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.