Active NPI
Edmundo A Somoza, M.D.
- Diagnostic Radiology Physician
- Napoleon, OH
National Provider Identifier
1700836566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35.049675
- Practice address
- 11600 State Route 424
Napoleon, OH 43545-9719 - Phone
- (419) 592-4015
- NPI assigned
- May 11, 2006
- Last updated
- Jul 8, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35.049675 | OH | Primary |
Addresses
Primary practice location
11600 State Route 424
Napoleon, OH 43545-9719
Mailing address
PO Box 1046
Lima, OH 45802-1046
Phone (419) 224-5707
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000391229 | Other | OH | ANTHEM BLUE CROSS BLUE SH |
| 0522581 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.049675 | OH | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fauster Cameron Inc. | Past | Accepting new patients | |
| Pro Rad, Inc | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Diagnostic Radiology Physician
- Bryan, OH
- NPI 1962470484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310083200000",
"number": "1700836566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1046",
"city": "LIMA",
"state": "OH",
"postal_code": "458021046",
"telephone_number": "419-224-5707",
"fax_number": "419-229-0040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11600 STATE ROUTE 424",
"city": "NAPOLEON",
"state": "OH",
"postal_code": "435459719",
"telephone_number": "419-592-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOMOZA",
"first_name": "EDMUNDO",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2011-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35.049675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "000000391229",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0522581",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Napoleon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.