Active NPI
Allen D Soffer, MD
- Cardiovascular Disease Physician
- St. Louis, MO
National Provider Identifier
1265425250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- R5F98
- Practice address
- 450 N. New Ballas Rd.
Suite 270 West Wing
St. Louis, MO 63141 - Phone
- (314) 991-6969
- Fax
- (314) 997-6969
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | R5F98 | MO | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 036-079446 | IL |
Addresses
Primary practice location
450 N. New Ballas Rd.
Suite 270 West Wing
St. Louis, MO 63141
Mailing address
450 N. New Ballas Rd.
Suite 270 West Wing
St. Louis, MO 63141
Phone (314) 991-6969
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881863009 | Other | MO | FARM GROUP NP |
| 007013185 | Other | MO | MEDICARE PROV ID AREA 99 |
| CD6536 | Other | MO | RR GROUP 01 |
| 001012762 | Other | MO | AREA 01 MEDICARE |
| 060041760 | Other | MO | RR MEDICARE NUMBER |
| 1124011010 | Other | MO | HHC CATH GROUP NPI |
| 1801889795 | Other | MO | STL GROUP NPI |
| CI7050 | Other | MO | RR GROUP 99 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-079446 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Overland Medical Center | Cardiovascular Disease | Past | Accepting new patients |
| Mercy Clinic Cardiovascular and Thoracic Surgery, LLC | Past | Accepting new patients |
Interoperability endpoints
- asoffer166696@direct.carenet.org
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.
-
- Vascular Surgery Physician
- Washington, MO
- NPI 1528192416
-
- Internal Medicine Physician
- Overland, MO
- NPI 1679637870
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453161600000",
"number": "1265425250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 N. NEW BALLAS RD.",
"address_2": "SUITE 270 WEST WING",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-991-6969",
"fax_number": "314-997-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 N. NEW BALLAS RD.",
"address_2": "SUITE 270 WEST WING",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-991-6969",
"fax_number": "314-997-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOFFER",
"first_name": "ALLEN",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2016-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MO",
"license": "R5F98",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036-079446",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FARM GROUP NP",
"identifier": "1881863009",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROV ID AREA 99",
"identifier": "007013185",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR GROUP 01",
"identifier": "CD6536",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AREA 01 MEDICARE",
"identifier": "001012762",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE NUMBER",
"identifier": "060041760",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HHC CATH GROUP NPI",
"identifier": "1124011010",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STL GROUP NPI",
"identifier": "1801889795",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR GROUP 99",
"identifier": "CI7050",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St. Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.