Individual provider Active NPI

Brendan David Sotomayor, M.D.

  • Emergency Medicine Physician
  • Viroqua, WI
National Provider Identifier
1306293311
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
75832-20 Issued in WI
Practice address
507 S Main St
Viroqua, WI 54665-2059
Phone
(608) 637-4202
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 75832-20 WI Primary

Addresses

Primary practice location

507 S Main St
Viroqua, WI 54665-2059

Mailing address

507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-4202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190910002288 IN Practitioner - Emergency Medicine 9537454962
I20220124000292 WI Practitioner - Emergency Medicine 9537454962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vernon Memorial Healthcare IncGroup PAC ID 8325958416, 73 clinicians

Practice addresses (Care Compare)

507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-2101

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vernon Memorial Healthcare, Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

Interoperability endpoints

  • Direct secure messaging: bsotomayor618019@direct.emplifyhealth.org

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 1

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": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1306293311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S MAIN ST",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652059",
            "telephone_number": "608-637-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOMAYOR",
        "first_name": "BRENDAN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "75832-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

Verify at the official NPI Registry.