Individual provider Active NPI

Wayne Soong, MD

  • Anesthesiology Physician
  • Aurora, CO
National Provider Identifier
1790796811
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036-111374 Issued in IL
Practice address
1700 Wheeling St
Aurora, CO 80045-7211
Phone
(720) 723-6230
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 036-111374 IL
Anesthesiology Physician 207L00000X 036-111374 IL Primary

Addresses

Primary practice location

1700 Wheeling St
Aurora, CO 80045-7211

Mailing address

1700 Wheeling St
Aurora, CO 80045-7211
Phone (720) 723-6230

Other practice location 1

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone (312) 695-9797

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

LicenseStateTypeSpecialty
036-111374ILMDCritical Care Medicine (Anesthesiology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1790796811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "720-723-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "720-723-6230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr",
            "address_2": "SUITE 1000",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114546",
            "country_code": "US",
            "telephone_number": "312-695-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOONG",
        "first_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IL",
            "license": "036-111374",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-111374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.