Sophia N. Mirviss, M.D., Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOPHIA N. MIRVISS, M.D., INC.

Practice address

3000 Colby St Ste 201
Berkeley, CA 94705-2058

Phone

(510) 843-0692

NPI assigned

Feb 3, 2020

Organization subpart

No

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

Authorized official

Name

Laurie Ervin

Title

Billing Manager

Phone

(925) 286-9039

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas J Cutillo, RN, MSN, FNP-C

  • Primary Care Nurse Practitioner
  • Berkeley, CA
  • NPI 1225201353
  Medicare reassignment Care Compare group NPD
• Sophia N Mirviss, M.D.

  • Family Medicine Physician
  • Berkeley, CA
  • NPI 1295874956
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1285265769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST STE 201",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052058",
            "telephone_number": "510-843-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLBY ST STE 201",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052058",
            "telephone_number": "510-843-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHIA N. MIRVISS, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "925-286-9039"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Song, LMFT
• Xiaoxia Song
• Susan Sonoda, PT
• Behram R Soonawala, M.D.
• Stephen Sooter, MS, RAS
• John Russell Sordean, OMD LAC ND
• Soreeyes Enterprises, Inc. (Site For Sore Eyes)
• Sharon Sorensen, D.C.
• Sorenson & Sorenson MD Inc
• Andrew Lee Sorenson, M.D.

• Primary Care Clinic/Center in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.