Individual provider Active NPI

Brian Alexander Soto, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1992207641
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.023345 Issued in OH
Practice address
5209 Detroit Ave
Cleveland, OH 44102-2224
Phone
(216) 651-2037
Fax
(216) 651-4145
NPI assigned
Mar 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 434715 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.023345 OH Primary

Addresses

Primary practice location

5209 Detroit Ave
Cleveland, OH 44102-2224

Mailing address

5209 Detroit Ave
Cleveland, OH 44102-2224
Phone (216) 651-4145

Other identifiers 1

IdentifierTypeStateIssuer
199220767641MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200125000243 OH Practitioner - Nurse Practitioner 0345675047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio North East Health Systems IncGroup PAC ID 1951395086, 34 clinicians

Practice addresses (Care Compare)

726 Wick Ave
Youngstown, OH 44505-2827
Phone 330747955177182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
434715OHMDRegistered Nurse
APRN.CNP.023345OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio North East Health Systems, Inc. CurrentSince Oct 18, 2021 Accepting new patients
Ohio North East Health Systems Inc CurrentSince Oct 18, 2021 Accepting new patients

Locations

716 Tod Ave SW
Warren, OH 44485
Phone (330) 373-0222

726 Wick Ave
Youngstown, OH 44505
Phone (330) 747-2330

Interoperability endpoints

  • Direct secure messaging: brian.soto.p1@direct.oho.nextgenshare.com
  • Direct secure messaging: brian.soto.p1@direct.neon.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1992207641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022224",
            "telephone_number": "216-651-4145",
            "fax_number": "216-651-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441022224",
            "telephone_number": "216-651-2037",
            "fax_number": "216-651-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "BRIAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "434715",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.023345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199220767641",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.