Active NPI
Agnes L So, MD
- Pediatrics Physician
- Brooklyn, NY
National Provider Identifier
1649207515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 213474-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01988903 | Medicaid | NY |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213474-1 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Care Medical Group PC | Pediatrics | Current | Accepting new patients |
| Chinatown True Care Medical PLLC | Pediatrics | Current | 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
- 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.
-
- Pediatrics Physician
- Brooklyn, NY
- NPI 1114080330
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1093777492
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.