Individual provider Active NPI

Timothy R. Soncasie, M.D.

  • Internal Medicine Physician
  • Columbia, MO
National Provider Identifier
1225058308
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
111504 Issued in MO
Practice address
900 W Nifong Blvd Ste 101
Columbia, MO 65203
Phone
(573) 499-9009
Fax
(573) 499-4400
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 111504 MO Primary
Pediatrics Physician 208000000X 111504 MO

Addresses

Primary practice location

900 W Nifong Blvd Ste 101
Columbia, MO 65203

Mailing address

900 W Nifong Blvd Ste 101
Columbia, MO 65203-4469
Phone (573) 499-9009

Other practice location 1

401 N Keene St
Columbia, MO 65201-6625
Phone (573) 876-1660

Other identifiers 2

IdentifierTypeStateIssuer
208504514MedicaidMO
P00349316OtherMORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20061003000174 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9234134834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Saint Louis University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians of St Lukes LLCGroup PAC ID 3779714142, 63 clinicians
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

11550 Olive Blvd
Saint Louis, MO 63141-7111
Phone (314) 542-7690

232 S Woods Mell Rd
Chesterfield, MO 63017-3417

233 Clarkson Rd
Ellisville, MO 63011-2219
Phone (636) 256-8644

5551 Winghaven Blvd
100 Winghaven UC Center
O Fallon, MO 63368-3618
Phone (636) 695-2500

8857 Ladue Rd a
Saint Louis, MO 63124-2045
Phone (314) 576-8189

900 W Nifong Blvd
Suite 101
Columbia, MO 65203-4469
Phone (573) 815-6640

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boone Physician Services, LLC CurrentSince Jan 1, 2021 Accepting new patients
Emergency Physicians of St. Luke'S, LLC Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

900 W Nifong Blvd
Ste 101
Columbia, MO 65203
Phone (573) 499-9009

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

508 Old Smizer Mill Rd
Fenton, MO 63026
Phone (636) 343-5223

232 S Woods Mill Rd
Town and Country, MO 63017
Phone (314) 205-6030

Interoperability endpoints

  • Direct secure messaging: timothysoncasie@mhccaremail.com

Organizations & group practices 2

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 6

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1225058308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034469",
            "telephone_number": "573-499-9009",
            "fax_number": "573-499-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W NIFONG BLVD STE 101",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-499-9009",
            "fax_number": "573-499-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N Keene St",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652016625",
            "country_code": "US",
            "telephone_number": "573-876-1660",
            "fax_number": "573-874-0665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONCASIE",
        "first_name": "TIMOTHY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "111504",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "111504",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208504514",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00349316",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.