Individual provider Active NPI

Jason Ian Soffa, D.O.

  • Family Medicine Physician
  • Warren, MI
National Provider Identifier
1194791368
Registry record updated Aug 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101015353 Issued in MI
Practice address
27450 Schoenherr Rd
Suite 400
Warren, MI 48088-6683
Phone
(586) 582-7550
Fax
(586) 582-7515
NPI assigned
Feb 27, 2006
Last updated
Aug 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101015353 MI Primary

Addresses

Primary practice location

27450 Schoenherr Rd
Suite 400
Warren, MI 48088-6683

Mailing address

27450 Schoenherr Rd
Suite 400
Warren, MI 48088-6683
Phone (586) 582-7550

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
I20060207000460 MI Practitioner - Family Practice 3870508211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27450 Schoenherr Rd
Suite 400
Warren, MI 48088-6684
Phone (586) 582-7550

27483 Dequindre Rd
Suite 204
Madison Heights, MI 48071-5711
Phone (248) 967-7326

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital Family Medicine CurrentSince Jun 15, 2007 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jun 15, 2007 Accepting new patients
Ascension Medical Group Michigan Family Medicine Past Accepting new patients
St John Oakland Hospital Past Accepting new patients

Locations

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

27450 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 582-7550

27472 Schoenherr Rd
Ste 130
Warren, MI 48088
Phone (586) 439-6243

Interoperability endpoints

  • Direct secure messaging: jsoffa1151960@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1194791368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27450 SCHOENHERR RD",
            "address_2": "SUITE 400",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886683",
            "telephone_number": "586-582-7550",
            "fax_number": "586-582-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27450 SCHOENHERR RD",
            "address_2": "SUITE 400",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886683",
            "telephone_number": "586-582-7550",
            "fax_number": "586-582-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFFA",
        "first_name": "JASON",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.