Individual provider Active NPI

Agnes L So, MD

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1649207515
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
213474-1 Issued in NY
Practice address
833 58TH Street
FL 1
Brooklyn, NY 11220-3609
Phone
(718) 686-8888
Fax
(718) 290-2913
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 213474-1 NY Primary

Addresses

Primary practice location

833 58TH Street
FL 1
Brooklyn, NY 11220-3609

Mailing address

366 5TH Ave
FL 4
New York, NY 10001-2241

Other practice location 1

863 50TH Street
FL 2 Suite M5
Brooklyn, NY 11220-6877
Phone (718) 686-8880

Other identifiers 1

IdentifierTypeStateIssuer
01988903MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000948 NY Practitioner - Pediatric Medicine 4789636457 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213474-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Group PC Pediatrics CurrentSince Jan 17, 2021 Accepting new patients
Chinatown True Care Medical PLLC Pediatrics CurrentSince Mar 24, 2025 Accepting new patients
Maimonides Medical Center Current Accepting new patients

Locations

833 58th St
Brooklyn, NY 11220
Phone (718) 290-2919

13527 38th Ave
Fl 2
Flushing, NY 11354
Phone (718) 362-6966

4235 Main St
Ste 3E
Flushing, NY 11355
Phone (718) 886-5068

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: agnesso@mai.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1649207515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 5TH AVE",
            "address_2": "FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 58TH STREET",
            "address_2": "FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203609",
            "telephone_number": "718-686-8888",
            "fax_number": "718-290-2913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "863 50TH STREET",
            "address_2": "FL 2  SUITE M5",
            "address_purpose": "LOCATION",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112206877",
            "country_code": "US",
            "telephone_number": "718-686-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SO",
        "first_name": "AGNES",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "213474-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01988903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.