Kelvin Yohanes Soewono, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T6045 Issued in TX

Practice address

1441 N Beckley Ave
Dallas, TX 75203-1201

Phone

(214) 947-6700

Fax

(214) 947-6701

NPI assigned

Apr 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Internal Medicine

Education

Rowan University School of Osteopathic Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Lonestar Hospital Medicine Associates PAGroup PAC ID 6709049703, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
• Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
• Medical City Arlington Hospital, Arlington, TX, CCN 450675
• Methodist Midlothian Medical Center Hospital, Midlothian, TX, CCN 670300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group

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

• Baylor Medical Center at Waxahachie

  • General Acute Care Hospital
  • Waxahachie, TX
  • NPI 1265430177
  Care Compare affiliation
• Columbia Medical Center of Arlington Subsidiary LP

  • General Acute Care Hospital
  • Arlington, TX
  • NPI 1134172406
  Care Compare affiliation
• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Midlothian, TX
  • NPI 1487271375
  Care Compare affiliation
• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Mansfield, TX
  • NPI 1689629941
  Care Compare affiliation

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1225667017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-6700",
            "fax_number": "214-947-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031201",
            "telephone_number": "214-947-6700",
            "fax_number": "214-947-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOEWONO",
        "first_name": "KELVIN",
        "middle_name": "YOHANES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T6045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Titilola Sode
• Preeti Sodhi, M.D.
• Henry Wayne Soechting, M.D.
• Leslie Karen Soehner, CRNA
• Todd Christopher Soesbe
• Patrick Sofer, DMD
• Heame Soffan, DO
• Sofia M Weigel MD PA
• Soh of Texas Samson Liu PLLC
• Eesha Rahimeen Sohail

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.