NPIMap

Individual provider Active NPI

Ronak Gajendrakumar Soni, M.D

  • Interventional Cardiology Physician
  • Conway, AR
National Provider Identifier
1871978676
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
E-15003 Issued in AR
Practice address
525 Western Ave Ste 202
Conway, AR 72034-4980
Phone
(501) 358-6905
Fax
(501) 255-6140
NPI assigned
Jul 22, 2015
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X E-15003 AR Primary

Addresses

Primary practice location

525 Western Ave Ste 202
Conway, AR 72034-4980

Mailing address

525 Western Ave Ste 202
Conway, AR 72034-4980
Phone (501) 358-6905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211118000711 MI Practitioner - Internal Medicine 2264726678 Reassigns benefits to 1 organization
I20220624001895 AR Practitioner - Interventional Cardiology 2264726678 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1159 Main St
Vilonia, AR 72173-9525
Phone (501) 358-6905

525 Western Ave
Suite 202
Conway, AR 72034-4980
Phone (501) 358-6905

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-15003ARMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Promed Healthcare CurrentSince Aug 10, 2021 Accepting new patients
Beacon Medical Group Michigan Inc Internal Medicine Current Accepting new patients
Conway Regional Medical Center, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Beacon Medical Group Michigan Inc Internal Medicine CurrentSince Aug 10, 2021 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients
Conway Regional Medical Center Inc Cardiovascular Disease Past Accepting new patients

Locations

525 Western Ave
Ste 202
Conway, AR 72034
Phone (501) 358-6905

525 Western Ave
Ste 302
Conway, AR 72034
Phone (501) 328-5515

1159 Main St
Vilonia, AR 72173
Phone (501) 796-2791

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1871978676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE STE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344980",
            "telephone_number": "501-358-6905",
            "fax_number": "501-255-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WESTERN AVE STE 202",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344980",
            "telephone_number": "501-358-6905",
            "fax_number": "501-255-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONI",
        "first_name": "RONAK",
        "middle_name": "GAJENDRAKUMAR",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "E-15003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.