Organization Active NPI

Somatus Medical Group, P.C.

  • Nephrology Physician
  • MC Lean, VA
National Provider Identifier
1902544646
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SOMATUS MEDICAL GROUP, P.C.
Practice address
1861 International Dr Ste 600
MC Lean, VA 22102-4420
Phone
(571) 992-0600
NPI assigned
May 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Authorized official

Name
Alicia J Palmer
Title
Secretary
Phone
(202) 236-7061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X Primary
Case Management Agency 251B00000X

Addresses

Primary practice location

1861 International Dr Ste 600
MC Lean, VA 22102-4420

Mailing address

1861 International Dr Ste 600
MC Lean, VA 22102-4420
Phone (571) 992-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NH, PA, VA, ME, WI, MI, IL, OH, KY, MD11 enrollments

Enrollment records 11

Enrollment IDStateProvider typePAC IDDetails
O20231228001260 TN Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Nashville, TN
O20240105001979 NH Part B Supplier - Clinic/Group Practice 2062862303 Practice locations: Concord, NH
O20240105003927 PA Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 2 practitioners
Practice locations: Philadelphia, PA
O20240108003490 VA Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Midlothian, VA
O20240202003041 ME Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, ME
O20240209001022 WI Part B Supplier - Clinic/Group Practice 2062862303 Practice locations: Sun Prairie, WI
O20240213003013 MI Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Plymouth, MI
O20240228003580 IL Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL
O20240301003587 OH Part B Supplier - Clinic/Group Practice 2062862303 Practice locations: Hilliard, OH
O20240322004147 KY Part B Supplier - Clinic/Group Practice 2062862303 Practice locations: Lexington, KY
O20240422002478 MD Part B Supplier - Clinic/Group Practice 2062862303 Receives reassigned benefits from 1 practitioner
Practice locations: Lutherville, MD

National Provider Directory

National Provider Directory

Locations

125 S Wacker Dr
Chicago, IL 60606
Phone (224) 407-2763

63 Pleasant St
Concord, NH 03301
Phone (562) 296-2730

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653264000000",
    "number": "1902544646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 INTERNATIONAL DR STE 600",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024420",
            "telephone_number": "571-992-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 INTERNATIONAL DR STE 600",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024420",
            "telephone_number": "571-992-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMATUS MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "202-236-7061"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.