Jeffrey Edward Sootin, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

048942 Issued in GA

Practice address

1800 Tree Lane Rd
Suite 330
Snellville, GA 30078-4700

Phone

(770) 978-0561

Fax

(770) 978-0546

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Surgery

Education

University of Miami, LM Miller School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Gwinnett Hospital, Lawrenceville, GA, CCN 110087
• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Advanced Neurosurgery Associates LLC

  • Neurological Surgery Physician
  • Lawrenceville, GA
  • NPI 1356959969
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Lawrenceville, GA
  • NPI 1952340994
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1912909573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 TREE LANE RD",
            "address_2": "SUITE 330",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784700",
            "telephone_number": "770-978-0561",
            "fax_number": "770-978-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TREE LANE RD",
            "address_2": "SUITE 330",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784700",
            "telephone_number": "770-978-0561",
            "fax_number": "770-978-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOTIN",
        "first_name": "JEFFREY",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "048942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020047989",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000880591C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880591A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Temitope Sobo
• Yanet Soca Castillo, RBT
• Social Network LLC
• Social Networks LLC
• Somali Children Health Care
• Marie Nicole Soracco, DC
• Sos Counseling and Consultation Group, LLC
• Sound Mind Counseling Services Inc
• South Gwinnett Radiology PC
• Southeast Urgent Care LLC

• Surgery Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.