Individual provider Active NPI

Jessica Soni, M.D.

  • Pediatrics Physician
  • Fishkill, NY
National Provider Identifier
1245673664
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
289056 Issued in NY
Practice address
600 Westage Business Ctr Dr
Fishkill, NY 12524-2281
Phone
(845) 231-5600
NPI assigned
Apr 16, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 289056 NY Primary

Addresses

Primary practice location

600 Westage Business Ctr Dr
Fishkill, NY 12524-2281

Mailing address

25710 Hillside Ave FL 2
Glen Oaks, NY 11004-1653
Phone (973) 460-7264

Other practice location 1

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (973) 460-7264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170825002868 NY Practitioner - Pediatric Medicine 9133491137 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
289056NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Aug 1, 2017 Accepting new patients
Optum Medical Care, P.C. Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

10 Cranberry Dr
Hopewell Junction, NY 12533
Phone (845) 896-6203

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245673664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25710 HILLSIDE AVE FL 2",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041653",
            "telephone_number": "973-460-7264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242281",
            "telephone_number": "845-231-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "973-460-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONI",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "289056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.