Individual provider Active NPI

Eric So, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Lincoln, NE
National Provider Identifier
1679969364
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
376 Issued in NE
Practice address
5055 A St Ste 400a
Lincoln, NE 68510-4957
Phone
(024) 483-4485
Fax
(402) 483-5372
NPI assigned
Apr 9, 2015
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Podiatrist 213E00000X POD-000905 AZ
Foot & Ankle Surgery Podiatrist 213ES0103X 376 NE Primary

Addresses

Primary practice location

5055 A St Ste 400a
Lincoln, NE 68510-4957

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190822003051 NE Practitioner - Podiatry 4981913811 Reassigns benefits to 1 organization
I20241206002649 KS Practitioner - Podiatry 4981913811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan Physician NetworkGroup PAC ID 7315915873, 236 clinicians

Practice addresses (Care Compare)

1600 S 48TH St
Lincoln, NE 68506-1299

19980 Buena Vista St
Stilwell, KS 66085-8601
Phone (402) 481-1111

2300 S 16TH St
Bryan Medical Center
Lincoln, NE 68502-3704
Phone (402) 481-1111

2731 Healthcare Dr
Syracuse, NE 68446-7880
Phone (402) 269-2011

5055 A St
Lincoln, NE 68510-4970

708 N 18TH St
Community Memorial Healthcare
Marysville, KS 66508-1338
Phone (785) 562-2311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of nail tissue94
Removal or shaving of skin growth75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD-000905AZMDPodiatrist
376NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan Physician Network CurrentSince Feb 1, 2021 Accepting new patients
Bryan Physician Network Podiatrist PastSince Jan 1, 2021 Accepting new patients
Northwoods Surgery Center LLC PastSince Sep 3, 2019 Accepting new patients

Locations

708 N 18th St
Marysville, KS 66508
Phone (785) 562-2311

2222 S 16th St
Ste 400A
Lincoln, NE 68502
Phone (402) 475-8877

2300 S 16th St
Lincoln, NE 68502
Phone (402) 434-6042

5055 A St
Ste 400
Lincoln, NE 68510
Phone (402) 483-3890

5055 A St
Ste 400A
Lincoln, NE 68510
Phone (402) 481-4485

Interoperability endpoints

  • Direct secure messaging: eso99059@hisp.bryanhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1679969364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 A ST STE 400A",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685104957",
            "telephone_number": "024-483-4485",
            "fax_number": "402-483-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "ERIC",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "POD-000905",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.