NPIMap

Individual provider Active NPI

Divjot Kaur Sooch, M.D.

  • Family Medicine Physician
  • Raynham, MA
National Provider Identifier
1275731853
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD13401 Issued in RI
Practice address
1215 Broadway
Raynham, MA 02767-1942
Phone
(508) 894-0400
Fax
(508) 894-0412
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD13401 RI Primary

Addresses

Primary practice location

1215 Broadway
Raynham, MA 02767-1942

Mailing address

1215 Broadway
Raynham, MA 02767-1942
Phone (508) 894-0400

Other identifiers 4

IdentifierTypeStateIssuer
1698301OtherMAMEDICARE PTAN
110085687AMedicaidMA
DS81690MedicaidRI
001698302OtherRIMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100909000295 MA Practitioner - Family Practice 3779608138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

1215 Broadway
Raynham, MA 02767-1942
Phone (508) 894-0400

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Family Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

1215 Broadway
Raynham, MA 02767
Phone (508) 828-3967

1470 New State Hwy
Raynham, MA 02767
Phone (508) 822-6800

Interoperability endpoints

  • Direct secure messaging: divjot.sooch@direct.signature.masshiway.net

Organizations & group practices 1

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1275731853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 BROADWAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671942",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 BROADWAY",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027671942",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOCH",
        "first_name": "DIVJOT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD13401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "1698301",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085687A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DS81690",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "001698302",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raynham, MA

Sources for this page

Verify at the official NPI Registry.