Individual provider Active NPI

Michael Dean Soe, MD

  • Diagnostic Radiology Physician
  • Fremont, NE
National Provider Identifier
1376589465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
18553 Issued in NE
Practice address
450 East 23Rd St
Fremont, NE 68025
Phone
(402) 721-3070
Fax
(402) 727-3513
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 18553 NE Primary

Addresses

Primary practice location

450 East 23Rd St
Fremont, NE 68025

Mailing address

415 E 23Rd St
Ste 210
Fremont, NE 68025-2393
Phone (402) 721-4866

Other identifiers 1

IdentifierTypeStateIssuer
47058135000MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 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
I20100729000026 NE Practitioner - Diagnostic Radiology 2466585369 Reassigns benefits to 1 organization
I20150520000931 IA Practitioner - Diagnostic Radiology 2466585369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Nebraska College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Radiology P CGroup PAC ID 2264323468, 37 clinicians
Iowa Diagnostic Imaging and Procedure Center, L CGroup PAC ID 1658263546, 36 clinicians

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6171

12368 Stratford Dr
Suite 300
Clive, IA 50325-8149
Phone (515) 228-9810

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1800

17102 Cora St
Bennington, NE 68007-5077
Phone (515) 226-9810

311 S Clark St
Carroll, IA 51401-3038
Phone (712) 794-5202

Hospital & facility affiliations

  • St Anthony Regional Hospital & Nursing Home Hospital, Carroll, IA, CCN 161382
  • Audubon County Memorial Hospital Hospital, Audubon, IA, CCN 161330
  • Guthrie County Hospital Hospital, Guthrie Center, IA, CCN 161314
  • Greene County Medical Center Hospital, Jefferson, IA, CCN 161325
  • Stewart Memorial Community Hospital Hospital, Lake City, IA, CCN 161350

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
78.95

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BTX Iowa Inc CurrentSince Sep 1, 2015 Accepting new patients
Iowa Diagnostic Imaging & Procedure Center, L C Diagnostic Radiology CurrentSince Jun 17, 2026 Accepting new patients
General Radiology PC Diagnostic Radiology Past Accepting new patients

Locations

12368 Stratford Dr
Ste 300
Des Moines, IA 50325
Phone (515) 228-9810

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

701 E 2nd St
Ida Grove, IA 51445
Phone (712) 364-3311

800 S Fillmore St
Osceola, IA 50213
Phone (641) 342-2184

1525 W 5th St
Storm Lake, IA 50588
Phone (712) 732-4030

Organizations & group practices 4

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 5

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376589465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E 23RD ST",
            "address_2": "STE 210",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252393",
            "telephone_number": "402-721-4866",
            "fax_number": "402-721-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 EAST 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "68025",
            "telephone_number": "402-721-3070",
            "fax_number": "402-727-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOE",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "18553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47058135000",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.