Individual provider Active NPI

Marianne Soden, D.O.

  • Internal Medicine Physician
  • Johnson City, NY
National Provider Identifier
1366416521
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
198444 Issued in NY
Practice address
507 Main St
Johnson City, NY 13790-1810
Phone
(607) 763-6075
NPI assigned
Feb 15, 2006
Last updated
Mar 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 198444 NY Primary

Addresses

Primary practice location

507 Main St
Johnson City, NY 13790-1810

Mailing address

33 Lewis Rd
2ND FL
Binghamton, NY 13905
Phone (607) 729-8156

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
I20050616000759 NY Practitioner - Internal Medicine 0244228948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
198444NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Mar 14, 2018 Accepting new patients
United Medical Associates PC Past Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients
New York Em-I Medical Services PC Past Accepting new patients
Dr. Marianne Soden Serjanej DO PLLC PastSince Nov 1, 2002 Accepting new patients
Bridgewater Center for Rehabilitation & Nursing LLC Past Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

2352 State Route 26
Endicott, NY 13760
Phone (607) 862-4325

30 Harrison St
Ste 320
Johnson City, NY 13790
Phone (607) 763-8205

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

507 Main St
Johnson City, NY 13790
Phone (607) 763-6075

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1366416521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 MAIN ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901810",
            "telephone_number": "607-763-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODEN",
        "first_name": "MARIANNE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.