NPIMap

Individual provider Active NPI

Daniel J Soetaert, DO

  • Physical Medicine & Rehabilitation Physician
  • Bremerton, WA
National Provider Identifier
1639465420
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
OP60563888 Issued in WA
Practice address
742 Lebo Blvd Ste a
Bremerton, WA 98310-3325
Phone
(360) 744-4950
Fax
(253) 572-1071
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X OP60563888 WA Primary

Addresses

Primary practice location

742 Lebo Blvd Ste a
Bremerton, WA 98310-3325

Mailing address

742 Lebo Blvd Ste a
Bremerton, WA 98310-3325
Phone (360) 744-4950

Other identifiers 1

IdentifierTypeStateIssuer
2046384MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsoetaert125902@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150722004359 WA Practitioner - Physical Medicine and Rehabilitation 0749593572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

742 Lebo Blvd
Suite a
Bremerton, WA 98310-3325
Phone (360) 744-4950

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1247
Removal of skin lesions36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60563888WAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

742 Lebo Blvd
Ste A
Bremerton, WA 98310
Phone (360) 744-4950

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: dsoetaert125902@fhsce.catholichealth.net

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1639465420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 LEBO BLVD STE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103325",
            "telephone_number": "360-744-4950",
            "fax_number": "253-572-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 LEBO BLVD STE A",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103325",
            "telephone_number": "360-744-4950",
            "fax_number": "253-572-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOETAERT",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "OP60563888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046384",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsoetaert125902@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "742 Lebo Blvd Ste A",
            "city": "Bremerton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983103325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.