Individual provider Active NPI

Cheryl Jittaun Joseph-Sonceau, O.D.

  • Optometrist
  • Suitland, MD
National Provider Identifier
1194867929
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1105 Issued in MD
Practice address
5100 Auth Way
Suitland, MD 20746
Phone
(301) 702-5000
Fax
(301) 702-5116
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP645 DC
Optometrist 152W00000X TA1105 MD Primary

Addresses

Primary practice location

5100 Auth Way
Suitland, MD 20746

Mailing address

2101 East Jefferson Street
Kaiser Permanente, Ppqa, 6 West, Attn Theresa Brooks
Rockville, MD 20852
Phone (301) 816-6660

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110513000399 DC Practitioner - Optometry 4183800881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

5100 Auth Way
Suitland, MD 20746-4207
Phone (301) 702-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP645DCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Optometrist Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 1997 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 1997 Accepting new patients

Locations

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
#6W
Rockville, MD 20852
Phone (301) 816-6660

5100 Auth Way
Suitland, MD 20746
Phone (301) 702-5000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1194867929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 EAST JEFFERSON STREET",
            "address_2": "KAISER PERMANENTE, PPQA, 6 WEST, ATTN THERESA BROOKS",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 AUTH WAY",
            "city": "SUITLAND",
            "state": "MD",
            "postal_code": "20746",
            "telephone_number": "301-702-5000",
            "fax_number": "301-702-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH-SONCEAU",
        "first_name": "CHERYL",
        "middle_name": "JITTAUN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "OP645",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5100 Auth Way",
            "city": "Suitland",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suitland, MD

Sources for this page

Verify at the official NPI Registry.