Jorge F Sotolongo, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

27364 Issued in IA

Practice address

201 Ridge St
#307
Council Bluffs, IA 51503-4643

Phone

(712) 329-5700

Fax

(712) 329-5759

NPI assigned

Aug 31, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 17

Medicare fee-for-service enrollment

Enrolled in IA, NE2 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

Specialty

Obstetrics/Gynecology

Education

University of Puerto Rico School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro OB GYN LLCGroup PAC ID 6608771803, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Metro OB GYN LLC

  • Obstetrics & Gynecology Physician
  • Council Bluffs, IA
  • NPI 1770501132

  NE

  Medicare reassignment Care Compare group NPD Authorized official
• Alegent Health Bergan Mercy Health System

  dba CHI Health Mercy Council Bluffs

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  NPD (past)
• Alegent Health Bergan Mercy Health System

  dba CHI Health Creighton University Medical Center-Bergan Mercy

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  NPD (past)
• Driver Chiropractic LLC

  • Occupational Health Chiropractor
  • Columbus, NE
  • NPI 1982026720
  NPD (past)
• MP-CC PC

  dba Midwest Pulmonary Critical Care PC

  • Pulmonary Disease Physician
  • Omaha, NE
  • NPI 1033226477
  NPD (past)

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

• Alegent Health Bergan Mercy Health System

  dba CHI Health Mercy Council Bluffs

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629189139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST",
            "address_2": "#307",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-329-5700",
            "fax_number": "712-329-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST",
            "address_2": "#307",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-329-5700",
            "fax_number": "712-329-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOLONGO",
        "first_name": "JORGE",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NE",
            "license": "18305",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "27364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSN",
            "identifier": "20108",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42150546518",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK-S. 24TH",
            "identifier": "97475",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025407200",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42150546520",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8171538",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK-CENTER",
            "identifier": "97476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK-ATLANTIC",
            "identifier": "06287",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3171538",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4171538",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK-201 RIDGE",
            "identifier": "22905",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3060582",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42150546517",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5171538",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK-LAKESIDE",
            "identifier": "97474",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7171538",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42150546516",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen C Smith, M.D.
• Mike Snook, RPH
• Jeremy Matthew Snow, CRNA
• Jill Renee Sobczyk, P.A.-C
• Marcella Louise Sorrell, FNP
• John G Southard, MD
• Southerncare, Inc (SouthernCare Counsil Bluffs)
• Southwest Iowa Health Ventures PLLC (Cityscape Healthcare)
• Southwest Iowa Spine Care
• Southwest Orthodontic Associates, PC

• Obstetrics & Gynecology Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Obstetrics & Gynecology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.