NPIMap

Individual provider Active NPI

Soemiwati Weidris Holland, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, NJ
National Provider Identifier
1740549864
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA10232900 Issued in NJ
Practice address
27 S Cooks Bridge Rd Ste 2-5
Jackson, NJ 08527-2524
Phone
(732) 987-5530
NPI assigned
May 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA10232900 NJ Primary

Addresses

Primary practice location

27 S Cooks Bridge Rd Ste 2-5
Jackson, NJ 08527-2524

Mailing address

27 S Cooks Bridge Rd Ste 2-5
Jackson, NJ 08527-2524
Phone (732) 987-5530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312001705 NJ Practitioner - Endocrinology 7719270131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

1828 W Lake Ave
Neptune, NJ 07753-4663
Phone (732) 869-5700

19 Davis Ave
Neptune, NJ 07753-4488

30 Prospect Ave
Hackensack, NJ 07601-1915

Hospital & facility affiliations

  • Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108
  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Endocrinology, Diabetes & Metabolism CurrentSince Feb 28, 2018 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

27 S Cooks Bridge Rd
Ste 2-5
Jackson, NJ 08527
Phone (732) 987-5530

19 Davis Ave
Fl 6
Neptune, NJ 07753
Phone (732) 897-3990

2240 State Route 33
Ste B
Neptune, NJ 07753
Phone (732) 897-3980

2240 State Route 33
Neptune City, NJ 07753
Phone (732) 897-3980

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: soemiwati.holland@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

Hospital & facility affiliations 8

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1740549864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD STE 2-5",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272524",
            "telephone_number": "732-987-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD STE 2-5",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272524",
            "telephone_number": "732-987-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "SOEMIWATI",
        "middle_name": "WEIDRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA10232900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

Verify at the official NPI Registry.