Individual provider Active NPI

Kevin Cerqueira Soares, M.D.

  • Surgical Oncology Physician
  • New York, NY
National Provider Identifier
1295977155
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
286381 Issued in NY
Practice address
1275 York Ave # C1272
New York, NY 10065
Phone
(212) 639-2000
NPI assigned
Mar 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 286381 NY Primary
Surgery Physician 208600000X 012680000 MA

Addresses

Primary practice location

1275 York Ave # C1272
New York, NY 10065

Mailing address

1275 York Ave # C1272
New York, NY 10065-6007
Phone (212) 639-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191231001178 NY Practitioner - Surgical OncologyPractitioner - General Surgery 0244487338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
University of Massachusetts Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mskcc Surgery GroupGroup PAC ID 0345131405, 365 clinicians
MSK HarrisonGroup PAC ID 1052634045, 134 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

500 Westchester Ave
West Harrison, NY 10604-3200
Phone (212) 639-2000

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
85.97 of 100Reported as group
Quality
82.74
Improvement activities
40
Cost
79.62

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
74.7
Improvement activities
40
Cost
69.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
012680000MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Surgery Group Surgery CurrentSince Oct 1, 2019 Accepting new patients
MSK Harrison Surgical Oncology CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital for Cancer and Allied Diseases Past Accepting new patients

Locations

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
#C1272
New York, NY 10065

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ksoares42108@mskcc.direct-ci.com

Organizations & group practices 3

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1295977155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE # C1272",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE # C1272",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "KEVIN",
        "middle_name": "CERQUEIRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NY",
            "license": "286381",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "012680000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.