Individual provider Active NPI

Mrugesh Indubhai Soni, MD

  • Interventional Cardiology Physician
  • Newport News, VA
National Provider Identifier
1508028937
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
0101261350 Issued in VA
Practice address
12720 McManus Blvd Ste 201
Newport News, VA 23602-4486
Phone
(757) 875-5332
Fax
(757) 806-6345
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 206144 LA
Interventional Cardiology Physician 207RI0011X 206144 LA
Interventional Cardiology Physician 207RI0011X 0101261350 VA Primary

Addresses

Primary practice location

12720 McManus Blvd Ste 201
Newport News, VA 23602-4486

Mailing address

860 Omni Blvd Ste 101
Newport News, VA 23606-4430
Phone (757) 232-8769

Other identifiers 1

IdentifierTypeStateIssuer
2337891MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161104001125 VA Practitioner - Interventional Cardiology 3577734243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

12720 McManus Blvd
Suite 201
Newport News, VA 23602-4486
Phone (757) 875-5332

2 Bernadine Dr
Newport News, VA 23602-4404
Phone (757) 886-6877

704 Thimble Shoals Blvd
300A
Newport News, VA 23606-4554
Phone (757) 595-4300

860 Omni Blvd
Newport News, VA 23606-4430

Hospital & facility affiliations

  • Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041
  • Bon Secours Maryview Medical Center Hospital, Portsmouth, VA, CCN 490017
  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Bon Secours Southampton Memorial Hospital Hospital, Franklin, VA, CCN 490092

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
206144LAMDCardiovascular Disease Physician
0101261350VAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Nov 1, 2016 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Nov 1, 2016 Accepting new patients

Locations

860 Omni Blvd
Ste 303
Newport News, VA 23606
Phone (757) 232-8777

860 Omni Blvd
Ste 101
Newport News, VA 23606
Phone (757) 223-9794

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

704 Thimble Shoals Blvd
#30
Newport News, VA 23606
Phone (757) 595-4300

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Newport News, VA 23606
Phone (757) 369-8138

12720 McManus Blvd
Ste 201
Newport News, VA 23602
Phone (757) 875-5332

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 2

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1508028937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD STE 101",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064430",
            "telephone_number": "757-232-8769",
            "fax_number": "757-232-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12720 MCMANUS BLVD STE 201",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024486",
            "telephone_number": "757-875-5332",
            "fax_number": "757-806-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONI",
        "first_name": "MRUGESH",
        "middle_name": "INDUBHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "206144",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "206144",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "VA",
            "license": "0101261350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2337891",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.