Individual provider Active NPI

Bruce Victor Soriano, MD

  • Internal Medicine Physician
  • Metuchen, NJ
National Provider Identifier
1861400475
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39098 Issued in NJ
Practice address
171 Amboy Ave
Metuchen, NJ 08840-2553
Phone
(732) 603-2220
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39098 NJ Primary

Addresses

Primary practice location

171 Amboy Ave
Metuchen, NJ 08840-2553

Mailing address

171 Amboy Ave
Metuchen, NJ 08840-2553
Phone (732) 603-2220

Other identifiers 3

IdentifierTypeStateIssuer
3421201MedicaidNJ
110171260OtherNJRAILROADMEDICARE#
223584206OtherNJTAX IDENTIFICATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20101130000898 NJ Practitioner - Internal Medicine 5193911378 Practice locations: Metuchen, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39098NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861400475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 AMBOY AVE",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402553",
            "telephone_number": "732-603-2220",
            "fax_number": "732-205-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 AMBOY AVE",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402553",
            "telephone_number": "732-603-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO",
        "first_name": "BRUCE",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "39098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3421201",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROADMEDICARE#",
            "identifier": "110171260",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "223584206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

Verify at the official NPI Registry.