Jason Soriano, PSY.D – Clinical Psychologist

Key facts

NPI: 1275920969
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Psychologist 103TC0700X
License: 071.009069 (IL)
Practice address: 3784 Fox Pointe
Rockford, IL 61114-7078
Phone: (608) 215-1110
Fax: (815) 395-0671
NPI assigned: Apr 20, 2015
Sex: Male
Sole proprietor: Yes

Organizations & group practices 4

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.

Jason Soriano, Psy.D., P.C. Community/Behavioral Health Agency · Rockford, IL · NPI 1588049274

Medicare reassignment NPD Authorized official IL
Aspen Counseling & Consulting LLC Community/Behavioral Health Agency · Rockford, IL · NPI 1326288994

Medicare reassignment NPD IL
Rockford Health Physicians Multi-Specialty Clinic/Center · Rockford, IL · NPI 1043242886

Medicare reassignment NPD IL
Aspen Counseling and Consulting LLC Mental Health Clinic/Center (Including Community Mental Health Center) · Madison, WI · NPI 1407287394

NPD

Medicare Care Compare profile

Specialty: Clinical Psychologist
Education: Other, 2013
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Telehealth: Offers telehealth services

Practice addresses (Care Compare)

973 Featherstone Rd
Suite 360
Rockford, IL 61107-5908
Phone (815) 520-0927

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IL
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20150526002590	IL	Practitioner - Clinical Psychologist	8022338490	Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
071.009069	IL	MD	Clinical Psychologist

Practice roles

Organization	Status	New patients
Aspen Counseling & Consulting LLC	Current since Sep 30, 2019	Accepting new patients
Aspen Counseling and Consulting LLC	Current since Sep 30, 2019	Accepting new patients
Rockford Health Physicians	Current since May 1, 2016	Accepting new patients
Jason Soriano, Psy.D., P.C.	Current since Jan 19, 2017	Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

8616 Northern Ave
Rockford, IL 61107
Phone (815) 332-8003

973 Featherstone Rd
Ste 360
Rockford, IL 61107
Phone (815) 395-1991

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist	103TC0700X	071.009069	IL	Yes

Addresses

Primary practice location

3784 Fox Pointe
Rockford, IL 61114-7078

Mailing address

3784 Fox Pointe
Rockford, IL 61114-7078
Phone (608) 215-1110

Other providers in Rockford, IL

All providers in Rockford, IL · Clinical Psychologist in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.