Individual provider Active NPI

Radim Soucek, MD

  • Emergency Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1598105082
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2016-0031 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1125
Fax
(505) 841-1737
NPI assigned
Jun 27, 2013
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X MD2016-0031 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, FL2 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
I20160701000305 NM Practitioner - Emergency Medicine 4688966187 Reassigns benefits to 1 organization
I20200731000624 FL Practitioner - Emergency Medicine 4688966187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2016-0031NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

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.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1598105082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1125",
            "fax_number": "505-841-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCEK",
        "first_name": "RADIM",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2016-0031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.