Dylan Boyd Soderstrum, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

341002 Issued in LA

Practice address

1215 Lee St
Charlottesville, VA 22908-0816

Phone

(434) 924-8485

Fax

(434) 982-4118

NPI assigned

Mar 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Emergency Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Tammany Emergency Physicians Group LLCGroup PAC ID 7214255967, 41 clinicians

C and M Medical Services IncGroup PAC ID 9436061553, 9 clinicians

Washington Parish Emergency Physicians Group LLCGroup PAC ID 4284928094, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045
• Terrebonne General Medical Center - Parish Hospital, Houma, LA, CCN 190008
• St James Parish Hospital Hospital, Lutcher, LA, CCN 191305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dsoderstrum586361@direct.casso.us.com

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.

• C & M Medical Services, Inc.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Metairie, LA
  • NPI 1710903059
  Medicare reassignment Care Compare group NPD
• St Tammany Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1891187654
  Medicare reassignment Care Compare group NPD
• Washington Parish Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Bogalusa, LA
  • NPI 1538511043
  Medicare reassignment Care Compare group NPD
• Riverside Emergency Physician Partners LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1083107080
  Medicare reassignment NPD
• East Jefferson Emergency Management LLC

  • Emergency Medicine Physician
  • Metairie, LA
  • NPI 1639684061
  Medicare reassignment
• Physician Practice Partners

  • Internal Medicine Physician
  • Houma, LA
  • NPI 1326598434
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Tammany Parish Hospital Service District No 1

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1083793582

  Hospital

  Care Compare affiliation
• St Tammany Parish Hospital Service District No 1

  • Pulmonary Disease Physician
  • Covington, LA
  • NPI 1285285874

  Hospital

  Care Compare affiliation
• St. James Parish Hosp. Serv. Dist.

  • Critical Access Hospital
  • Lutcher, LA
  • NPI 1588654966
  Care Compare affiliation
• St. Tammany Parish Hospital Service District No 1

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1598798597
  Care Compare affiliation
• Terrebonne Parish Hospital Service District #1

  • General Acute Care Hospital
  • Houma, LA
  • NPI 1518924109
  Care Compare affiliation

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1720664188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-8485",
            "fax_number": "434-982-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERSTRUM",
        "first_name": "DYLAN",
        "middle_name": "BOYD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "341002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vusala Snyder, MD
• Sherra So
• Mark R. Sochor, MD
• Emily B Socolow, ACPNP
• James Paul Soderquist, DDS
• Amna Sohail, M.D.
• Jennifer Sokolowski, M.D, PH.D.
• Nina J. Solenski
• Ricardo Belinchon Solis, DDS
• James Michael Solomon, DDS

• Emergency Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.