NPIMap

Individual provider Active NPI

Beck Soderberg, MD

  • Family Medicine Physician
  • Devon, PA
National Provider Identifier
1205925682
Registry record updated Feb 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD066886L Issued in PA
Practice address
139 Berkeley Rd
Devon, PA 19333-1544
Phone
(610) 687-0715
Fax
(610) 964-1228
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2011

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 MD066886L PA Primary

Addresses

Primary practice location

139 Berkeley Rd
Devon, PA 19333-1544

Mailing address

139 Berkeley Rd
Devon, PA 19333-1544
Phone (610) 687-0715

Other identifiers 1

IdentifierTypeStateIssuer
800558OtherPAMEDICARE ID TYPE UNSPECIFIED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20101229000677 PA Practitioner - Family Practice 3274552450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Devon Family Practice LLPGroup PAC ID 8224218078, 8 clinicians

Practice addresses (Care Compare)

139 Berkley Rd
Devon, PA 19333-1544
Phone (610) 687-0715

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Devon Family Practice LLP Family Medicine CurrentSince Nov 9, 2010 Accepting new patients
Pinnacle Medical Group, Inc. Past Accepting new patients
Doctors Best Immediate Medical Care Inc Past Accepting new patients

Locations

139 Berkley Rd
Devon, PA 19333
Phone (610) 687-0715

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFDDBA

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.

Hospital & facility affiliations 8

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298592000000",
    "number": "1205925682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 BERKELEY RD",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331544",
            "telephone_number": "610-687-0715",
            "fax_number": "610-964-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 BERKELEY RD",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331544",
            "telephone_number": "610-687-0715",
            "fax_number": "610-964-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERBERG",
        "first_name": "BECK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD066886L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "800558",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devon, PA

Sources for this page

Verify at the official NPI Registry.