NPIMap

Individual provider Active NPI

Stephen M Sorensen, MD

  • Family Medicine Physician
  • Davenport, IA
National Provider Identifier
1881647071
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31344 Issued in IA
Practice address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone
(563) 421-4400
Fax
(563) 421-4449
NPI assigned
May 18, 2006
Last updated
May 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31344 IA Primary

Addresses

Primary practice location

1345 W Central Park Ave
Davenport, IA 52804-1844

Mailing address

1345 W Central Park Ave
Davenport, IA 52804-1844
Phone (563) 421-4400

Other identifiers 1

IdentifierTypeStateIssuer
8128298MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephen.sorensen@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20051107000248 IA Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Emergency Medicine 1759273204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

1345 W Central Park Ave
Mercyone Genesis Family Medical Cen
Davenport, IA 52804-1844
Phone (563) 421-4400

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31344IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Dec 28, 2021 Accepting new patients
Genesis Health System Family Medicine CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System Family Medicine CurrentSince Dec 28, 2021 Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Jackson County Public Hospital Past Accepting new patients
Family Health Partners of the Quad Cities, PC Family Medicine Past Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Genesis Health System Past Accepting new patients

Locations

2535 Maplecrest Rd
Ste 10
Bettendorf, IA 52722
Phone (319) 344-3500

2546 Tech Dr
Bettendorf, IA 52722
Phone (563) 421-5400

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

619 5th St
Durant, IA 52747
Phone (563) 785-4487

Interoperability endpoints

  • Direct secure messaging: stephen.sorensen@direct.genesishealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercyone GenesisBettendorf, IA, CCN 161520 Hospice W-2 Managing Employee Mar 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 3

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1881647071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4400",
            "fax_number": "563-421-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4400",
            "fax_number": "563-421-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-05-14",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "31344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8128298",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephen.sorensen@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.