Individual provider Active NPI

Mohsen Soofian, D.O.

  • Family Medicine Physician
  • South Miami, FL
National Provider Identifier
1265880520
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS16766 Issued in FL
Practice address
7031 SW 62ND Ave
South Miami, FL 33143-4701
Phone
(206) 898-1317
NPI assigned
May 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 295215 NY
General Practice Physician 208D00000X DO.1791 AL
Student in an Organized Health Care Education/Training Program 390200000X WA
Family Medicine Physician 207Q00000X OS16766 FL Primary

Addresses

Primary practice location

7031 SW 62ND Ave
South Miami, FL 33143-4701

Mailing address

7031 SW 62ND Ave
South Miami, FL 33143-4701

Other practice location 1

98-1247 Kaahumanu St Ste 116
Aiea, HI 96701-5300
Phone (808) 341-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL, HI, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20210917002565 AL Practitioner - General Practice 4385976018 Reassigns benefits to 2 organizations
I20220221001352 FL Practitioner - General Practice 4385976018
I20220224001233 HI Practitioner - General Practice 4385976018 Reassigns benefits to 1 organization
I20230720003746 NY Practitioner - Family Practice 4385976018 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.1791ALMDGeneral Practice Physician
21381CAMDPhysical Therapist
1791ALMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
CTD Network LLC General Practice CurrentSince Jun 21, 2023 Accepting new patients
Openloop Healthcare Partners California PC General Practice Current Accepting new patients
Openloop Healthcare Partners California PC General Practice CurrentSince Jul 17, 2023 Accepting new patients
Signify Health, LLC General Practice CurrentSince Jun 10, 2021 Accepting new patients
Openloop Healthcare Partners PC General Practice CurrentSince May 17, 2023 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

1430 Gadsden Hwy
Ste 116805
Birmingham, AL 35235

2100 Southbridge Pkwy
Ste 650
Homewood, AL 35209
Phone (205) 533-8902

2121 E Coast Hwy
Ste 270
Corona del Mar, CA 92625
Phone (949) 694-4937

8270 Woodland Center Blvd
Tampa, FL 33614
Phone (305) 449-9219

500 Ala Moana Blvd
Ste 7400
Honolulu, HI 96813
Phone (617) 823-6490

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

442 5th Ave
#2115
New York, NY 10018

28 Liberty St
New York, NY 10005
Phone (415) 205-1229

80 Broad St
Fl 5
New York, NY 10004
Phone (201) 286-1122

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1265880520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701",
            "telephone_number": "206-898-1317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98-1247 Kaahumanu St Ste 116",
            "address_purpose": "LOCATION",
            "city": "Aiea",
            "state": "HI",
            "postal_code": "967015300",
            "country_code": "US",
            "telephone_number": "808-341-4747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOOFIAN",
        "first_name": "MOHSEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "295215",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "DO.1791",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.