Individual provider Active NPI

Fernando Augusto Soares, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1790925311
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
7406 Issued in SD
Practice address
8585 Picardy Ave
Baton Rouge, LA 70809-3748
Phone
(225) 397-1812
NPI assigned
Feb 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 7406 SD Primary

Addresses

Primary practice location

8585 Picardy Ave
Baton Rouge, LA 70809-3748

Mailing address

PO Box 148
Prairieville, LA 70769-9997
Phone (225) 433-2830

Other identifiers 1

IdentifierTypeStateIssuer
6632230MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090810000606 SD Practitioner - Pediatric MedicinePractitioner - Other (Physician) 2860546876 Reassigns benefits to 1 organization
I20230815003352 LA Practitioner - Pediatric Medicine 2860546876 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7406SDMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neokids LLC Neonatal-Perinatal Medicine CurrentSince May 3, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan CurrentSince Jul 27, 2009 Accepting new patients
Avera McKennan CurrentSince Jul 27, 2009 Accepting new patients
Baton Rouge General Medical Center Past Accepting new patients

Locations

8585 Picardy Ave
Baton Rouge, LA 70809
Phone (225) 763-4000

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1235260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1790925311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707699997",
            "telephone_number": "225-433-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 PICARDY AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093748",
            "telephone_number": "225-397-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "FERNANDO",
        "middle_name": "AUGUSTO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-22",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "SD",
            "license": "7406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6632230",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.