Active NPI
Somatus Ipa, LLC
- Case Management Agency
- Bohemia, NY
National Provider Identifier
1366024648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.