Organization Active NPI

Somatus Ipa, LLC

  • Case Management Agency
  • Bohemia, NY
National Provider Identifier
1366024648
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SOMATUS IPA, LLC
Practice address
80 Orville Dr Ste 100
Bohemia, NY 11716-2505
Phone
(571) 992-0600
NPI assigned
Apr 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Alicia J Palmer
Title
Authorized Official
Phone
(202) 236-7061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X

Addresses

Primary practice location

80 Orville Dr Ste 100
Bohemia, NY 11716-2505

Mailing address

1861 International Dr Ste 600
MC Lean, VA 22102-4420
Phone (703) 955-2941

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1366024648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 INTERNATIONAL DR STE 600",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024420",
            "telephone_number": "703-955-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ORVILLE DR STE 100",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162505",
            "telephone_number": "571-992-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMATUS IPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "202-236-7061"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.