Katarina Rosari Soewono, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A183157 Issued in CA

Practice address

4770 W Herndon Ave Ste 110
Fresno, CA 93722-8401

Phone

(559) 450-0463

Fax

(559) 450-0464

NPI assigned

Apr 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Agnes Medical Foundation 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

Merit-based Incentive Payment System (MIPS)

Final score

88 of 100Reported as individual

Quality

84.34

Promoting interoperability

71

Improvement activities

40

Cost

76.97

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Saint Agnes Medical Foundation

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1558819482

  CA, Family Medicine

  Medicare reassignment Care Compare group NPD
• LQMG Medical Group Inc.

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1437166360
  NPD
• Fresno Community Hospital and Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1104906569
  NPD (past)

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

• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1366062408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SPRUCE AVE STE 431",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203330",
            "telephone_number": "559-450-7449",
            "fax_number": "559-450-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 W HERNDON AVE STE 110",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228401",
            "telephone_number": "559-450-0463",
            "fax_number": "559-450-0464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 E Herndon Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203306",
            "country_code": "US",
            "telephone_number": "559-450-4637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOEWONO",
        "first_name": "KATARINA",
        "middle_name": "ROSARI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-18",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A183157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Olumuyiwa Sodeke, MD
• Gurvir Sodi
• John H. Soebagio, MD
• Tamara Annette Soemali, BCBA
• Lindsey Soennichsen, LMFT
• Quincy Izabela Sofowora, DDS
• Softmedcare LLC
• Ara Karnik Soghomonian, MD
• Harpreet Sohal
• Paramjeet Sohal

• All providers in Fresno, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.