DR. MICHELLE A SOTO MD
NPI 1396731410
Family Medicine in Waupaca, WI

Q: What is Michelle Soto's NPI number?

The NPI number for Michelle Soto is 1396731410. It was assigned to this individual provider in the NPPES registry on September 23, 2005. The provider is also known as Dr. Michelle A Thomas MD.

Q: What is Michelle Soto's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Soto was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment

710 RIVERSIDE DR, WAUPACA, WI 54981(715) 256-3000(715) 256-3039 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Jun 27, 2016 (2 updates tracked since 2016).

On this page

About Dr. Michelle A Soto Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHELLE A SOTO MD (NPI 1396731410) is an individual family medicine provider in Waupaca, Wisconsin, licensed in Wisconsin (51829) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of University Of Wisconsin School Of Medicine (1999).

NPPES Registry Identity

NPI1396731410

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. MICHELLE A SOTOCredential: MD

Location Address710 RIVERSIDE DRWaupaca, WI 54981-1941

Mailing AddressPo Box 8003Appleton, WI 54912-8003 · (920) 996-3200 · Fax (920) 738-5787

Phone(715) 256-3000

Fax(715) 256-3039

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1999

Enumeration DateSeptember 23, 2005

Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration

✔ NPI 1396731410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in WI · 51829✔ Licensed in OR · MD23927

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

710 RIVERSIDE DR, Waupaca, WI 54981

Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Michelle A Thomas Md

Other Identifiers 1

Medicaid000563OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michelle A Soto Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012069347

PECOS Enrollment IDI20090717000458

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

364 services223 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

116 services116 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

66 services56 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

46 services45 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

37 services36 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520045

Location130 2nd StNeenah, WI 54956 · Winnebago County

Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520160

Location1818 N Meade StAppleton, WI 54911 · Outagamie County

Emergency services Birthing friendly

Thedacare Medical Center - Wild Rose

Critical Access Hospitals · Wild Rose, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521303

Location601 Grove AveWild Rose, WI 54984 · Waushara County

Emergency services

Thedacare Medical Center-Waupaca

Critical Access Hospitals · Waupaca, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521334

Location800 Riverside DriveWaupaca, WI 54981 · Waupaca County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54981 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers36 claims108 services$6.35 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

6 suppliers16 claims20 services$1.14 avg. paid by Medicare

Male external catheter, with or without adhesive, disposable, each A4349

DME-Medical/Surgical Supplies · category DA000N

1 supplier13 claims420 services$1.94 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers25 claims25 services$20.58 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers47 claims47 services$111.62 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

7 suppliers48 claims48 services$186.43 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT WILLIAM SEDLACEK M.D.

Family Medicine