TREVOR M SOERGEL MD
NPI 1649267725
Urology in Jeffersonville, IN

Q: What is Trevor Soergel's NPI number?

The NPI number for Trevor Soergel is 1649267725. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Q: What is Trevor Soergel's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Trevor Soergel was last updated on October 24, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 October 04, 2005PECOS EnrolledAccepts Medicare Assignment

76.2/100

CMS Quality Rating

101 HOSPITAL BLVD., JEFFERSONVILLE, IN 47130(812) 282-3899(812) 282-4172 Get Directions Write a Review

NPPES record last updated: October 24, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Trevor M Soergel Md NPPES

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

TREVOR M SOERGEL MD (NPI 1649267725) is an individual urology provider in Jeffersonville, Indiana, licensed in Indiana (01053673A) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Clark Memorial Hospital, and is a graduate of University Of Louisville School Of Medicine (1999).

NPPES Registry Identity

NPI1649267725

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameTREVOR M SOERGELCredential: MD

Location Address101 HOSPITAL BLVD.Jeffersonville, IN 47130-3748

Mailing Address101 Hospital Blvd.Jeffersonville, IN 47130-3748 · (812) 282-3899 · Fax (812) 282-4172

Phone(812) 282-3899

Fax(812) 282-4172

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1999

Enumeration DateOctober 4, 2005

Last NPPES UpdateOctober 24, 2007

✔ NPI 1649267725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

Licenses✔ Licensed in IN · 01053673A✔ Licensed in KY · 38741

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

101 HOSPITAL BLVD., Jeffersonville, IN 47130

Open in Google Maps ↗

Other Identifiers 6

Medicare UPINI28338

Medicare ID-Type Unspecified122620SIN

OtherP00238795IN · Rr Mcr

Medicare ID-Type Unspecified1165019KY

OtherP00251775KY · Rr Mcr

Medicaid64101983KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Trevor M Soergel 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 ID8628018801

PECOS Enrollment IDI20050506000299, I20050516000613

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.

Medicare Billing Reassignments

Medicare enrollment records show Trevor Soergel reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

First Urology, Psc

Same address

Urology

101 HOSPITAL BLVD
Jeffersonville, IN 47130

Reassigned Medicare billing, Indiana and Kentucky enrollments
65 clinicians in this Medicare group

NPI 1922099811 (812) 282-3899

Norton - Kings Daughters Health Inc

41 mi

Family Medicine

1373 E STATE ROAD 62
Madison, IN 47250

Reassigned Medicare billing, Indiana enrollment
142 clinicians in this Medicare group

NPI 1114955093 (812) 801-0800

Jackson County Schneck Memorial Hospital

47 mi

Anesthesiology

411 W TIPTON ST
Seymour, IN 47274

Reassigned Medicare billing, Indiana enrollment
169 clinicians in this Medicare group

NPI 1629143037 (812) 522-2349

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 46

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.

1,001 services757 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

983 services758 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

775 services648 patients

Leuprolide injectable, camcevi, 1 mg J1952

Camcevi, containing 1 mg of Leuprolide, is an injectable medication. It's used to manage certain health conditions by influencing hormone levels in your body. It's administered by a healthcare professional, usually once every month or as directed by your doctor.

714 services15 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

706 services130 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

472 services425 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

393 services370 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

354 services333 patients

Blood creatinine level 82565

A blood creatinine level test measures the amount of creatinine in your blood. Creatinine is a waste product that your body produces when it uses energy. High levels may indicate that your kidneys aren't working properly. This test is often used to monitor kidney health.

340 services325 patients

Ct scan of abdomen and pelvis before and after contrast 74178

A CT scan of your abdomen and pelvis with and without contrast helps visualize your internal organs better. Contrast is a special dye that improves the clarity of the images. It's taken orally or injected into your veins before the scan. The process is painless and quick.

256 services251 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

189 services163 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

148 services147 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.

138 services131 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

136 services73 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

113 services113 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

94 services68 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

92 services82 patients

Complete laser fragmentation of prostate including control of bleeding using an endoscope 52649

This procedure involves using a special scope and a laser to break down an enlarged gland in the lower body, improving comfort and function. It also includes managing any bleeding that may occur during this process.

72 services72 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

64 services63 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

51 services45 patients

Simple insertion of temporary bladder tube 51702

This procedure involves placing a temporary tube into your bladder to help with urine flow. It's done when the body can't naturally remove urine. The tube is inserted through a small opening and allows urine to drain into a bag. It's usually a short-term solution.

48 services30 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

45 services44 patients

Ct scan of abdomen before and after contrast 74170

A CT scan of the abdomen before and after contrast is a diagnostic procedure. It involves taking detailed images of your abdomen area. Initially, images are taken without a contrast agent. Then, a contrast dye is given to highlight specific areas inside your body, helping to provide clearer images for better diagnosis.

44 services41 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

42 services36 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

41 services41 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

39 services35 patients

Removal or manipulation of stone in ureter or kidney using an endoscope 52352

This procedure involves using a thin, flexible instrument called an endoscope to locate and remove or break down stones in the urinary tract. It's a non-invasive method that helps to alleviate discomfort and improve urinary function.

37 services33 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

32 services32 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

31 services26 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

31 services31 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

29 services29 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

28 services27 patients

Ultrasound scan of pelvic region through rectum 76872

28 services28 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

27 services27 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

26 services26 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

25 services23 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

25 services24 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

25 services22 patients

Complete ultrasound scan of pelvis 76856

A complete ultrasound scan of the pelvis is a safe, non-invasive imaging procedure. It uses sound waves to create pictures of your lower abdomen area, helping doctors to evaluate and diagnose any potential issues. It's painless and usually takes about 30 minutes.

21 services21 patients

Biopsy of bladder using an endoscope 52204

A biopsy of the bladder using an endoscope is a procedure where a small sample of bladder tissue is collected for testing. An endoscope, a flexible tube with a light and camera, is used to see inside the bladder. This helps to identify any abnormal areas. The procedure helps in the diagnosis of various conditions.

17 services14 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

16 services15 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

15 services14 patients

Irrigation and removal of multiple blood clots from bladder and urethra using an endoscope 52001

This procedure involves using a small tube with a camera (endoscope) to view and clear multiple blood clots from the bladder and urethra. It involves washing (irrigation) and removing clots to restore normal flow.

13 services13 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

13 services11 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

13 services13 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Clark Memorial Hospital

Acute Care Hospitals · Jeffersonville, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number150009

Location1220 Missouri AveJeffersonville, IN 47130 · Clark County

Emergency services Birthing friendly

Baptist Health Floyd

Acute Care Hospitals · New Albany, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150044

Location1850 State StNew Albany, IN 47150 · Floyd County

Emergency services Birthing friendly

Physicians' Medical Center LLC

Acute Care Hospitals · New Albany, IN

OwnershipPhysician

CMS Certification Number150172

Location4023 Reas LnNew Albany, IN 47150 · Floyd County

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180088

Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180130

Location4000 Kresge WayLouisville, KY 40207 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47130 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

76.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.25

Promoting Interoperability

Improvement Activities

Cost

68.75

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.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

4 suppliers36 claims4,870 services$1.43 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

5 suppliers71 claims11,186 services$5.19 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

2 suppliers17 claims48 services$6.97 avg. paid by Medicare

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385

DME-Orthotic Devices · category DF010N

1 supplier13 claims420 services$4.59 avg. paid by Medicare

Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409

DME-Orthotic Devices · category DF010N

1 supplier12 claims360 services$6.00 avg. paid by Medicare

Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432

DME-Orthotic Devices · category DF010N

1 supplier13 claims380 services$3.47 avg. paid by Medicare

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

Other Providers at the Same Location NPPES 4

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

GANESH S RAO MD

Urology

101 HOSPITAL BLVD.
JEFFERSONVILLE, IN 47130

Clark County (812) 282-3899

WILLIAM K SCHMIED MD

Urology

101 HOSPITAL BLVD.
JEFFERSONVILLE, IN 47130

Clark County (812) 282-3899

JAMES L BAILEN MD

Urology

101 HOSPITAL BLVD.
JEFFERSONVILLE, IN 47130

Clark County (812) 282-3899

GREG S STEINBOCK MD

Urology

101 HOSPITAL BLVD.
JEFFERSONVILLE, IN 47130

Clark County (812) 282-3899

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trevor Soergel's NPI number?

The NPI number for Trevor Soergel is 1649267725. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Trevor Soergel located?

Trevor Soergel practices at 101 Hospital Blvd., Jeffersonville, IN 47130. The listed phone number is (812) 282-3899.

What is Trevor Soergel's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Trevor Soergel enrolled in Medicare?

Yes. Trevor Soergel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Trevor Soergel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Trevor Soergel reassigns Medicare benefits to 3 organizations: First Urology, Psc (Jeffersonville, IN), Norton - Kings Daughters Health Inc (Madison, IN) and Jackson County Schneck Memorial Hospital (Seymour, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Trevor Soergel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Trevor Soergel accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Trevor Soergel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Trevor Soergel affiliated with any hospitals?

According to CMS data, Trevor Soergel is affiliated with Clark Memorial Hospital, Baptist Health Floyd, Physicians' Medical Center LLC, Norton Hospitals, Inc and Baptist Health Louisville.

When was this NPI record last updated?

The NPPES record for Trevor Soergel was last updated on October 24, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.