NPIMap

Individual provider Active NPI

Michael C Soulen, MD

  • Vascular & Interventional Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1447296579
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD044138E Issued in PA
Practice address
3400 Spruce St
Ground Floor Dulles
Philadelphia, PA 19104
Phone
(215) 662-3005
Fax
(215) 662-7011
NPI assigned
Jun 20, 2006
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X MD044138E PA Primary

Addresses

Primary practice location

3400 Spruce St
Ground Floor Dulles
Philadelphia, PA 19104

Mailing address

3400 Spruce St
Ground Flor Dulles
Philadelphia, PA 19104

Other identifiers 1

IdentifierTypeStateIssuer
0012472540005MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040330001070 PA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 7416949797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Perelman School of Med at the University of Pennsylvania, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 349-5454

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn - Medical Group CurrentSince May 1, 2015 Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Univ of Penn Community Radiology Vascular & Interventional Radiology Past Accepting new patients

Locations

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
#588
Philadelphia, PA 19104
Phone (800) 998-4505

3737 Market St
Philadelphia, PA 19104
Phone (215) 294-9393

250 King of Prussia Rd
Ste 3
Radnor, PA 19087
Phone (610) 902-1800

250 King of Prussia Rd
Radnor, PA 19087
Phone (610) 902-1800

420 W Linfield Trappe Rd
Royersford, PA 19468
Phone (610) 279-8686

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1349308800000",
    "number": "1447296579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "GROUND FLOR DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "GROUND FLOOR DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-3005",
            "fax_number": "215-662-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULEN",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "MD044138E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012472540005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.