JOHN R SODERSTROM P.A.
NPI 1871506931
Physician Assistant in Peoria, IL

Q: What is John Soderstrom's NPI number?

The NPI number for John Soderstrom is 1871506931. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Q: What is John Soderstrom's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for John Soderstrom was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

4909 N GLEN PARK PLACE RD, PEORIA, IL 61614(309) 674-7546 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About John R Soderstrom P.a. NPPES

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

JOHN R SODERSTROM P.A. (NPI 1871506931) is an individual physician assistant in Peoria, Illinois and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1871506931

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJOHN R SODERSTROMCredential: P.A.

Location Address4909 N GLEN PARK PLACE RDPeoria, IL 61614-4676

Mailing Address4909 N Glen Park Place RdPeoria, IL 61614-4676 · (309) 674-7546

Phone(309) 674-7546

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateAugust 13, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1871506931 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4909 N GLEN PARK PLACE RD, Peoria, IL 61614

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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

John R Soderstrom P.a. 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 ID6406858125

PECOS Enrollment IDI20100714000295

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 23

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

6,506 services737 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.

2,226 services1,230 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

1,239 services817 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

370 services265 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

274 services135 patients

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.

242 services151 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

227 services114 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 11311

This procedure involves removing a small skin growth on the face or related areas like the ears, eyelids, nose, lips, or mouth. The growth is gently shaved off, typically under local anesthesia. It's a quick, safe process for growths between 0.6-1.0 cm in size.

212 services162 patients

Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm 11301

This procedure involves the careful removal of a small skin growth on the body, arms, or legs. It's done by shaving off the growth that's 0.6-1.0 cm in size. It's a common, safe method to treat non-cancerous skin growths and improve skin appearance.

209 services164 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

170 services149 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm 11306

This procedure involves the careful removal of a small skin growth, between 0.6-1.0 cm in size, from the scalp, neck, hands, or feet. It's done using a special tool to gently shave off the growth, ensuring minimal discomfort.

83 services72 patients

Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm 11302

This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.

58 services51 patients

Removal of skin tag, 1-15 skin tags 11200

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

50 services44 patients

Injection into skin growth, 1-7 growths 11900

This procedure involves injecting medication into 1-7 skin growths. The medication helps to reduce the size of the growths or completely eliminate them. It's a simple, quick, and usually painless process performed by a medical professional.

49 services34 patients

Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm 17281

This procedure involves the removal of cancerous skin growths on the face, ears, eyelids, nose, lips, or mouth that are between 0.6-1.0 cm in size. The goal is to eliminate cancer cells, preventing further spread and promoting health.

32 services27 patients

Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm 17261

This procedure involves the removal of a cancerous skin growth on the trunk, arms, or legs that is between 0.6 and 1.0 cm in size. The goal is to eliminate the cancerous cells and prevent further spread. The method of destruction may vary, including methods such as surgery, laser, or cryotherapy.

27 services20 patients

Punch biopsy, first skin growth 11104

A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.

25 services24 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

23 services23 patients

Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm 11312

This procedure involves the careful removal of a skin growth on the face, ears, eyelids, nose, lips, or mouth. The growth being treated is between 1.1 and 2.0 cm in size. The process is typically quick, with minimal discomfort, and aids in maintaining skin health.

20 services19 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

17 services17 patients

Acne surgery 10040

Acne surgery is a procedure to clear up severe acne that doesn't respond to other treatments. It involves a dermatologist using specialized tools to remove blackheads, whiteheads, and pimples. This helps to reduce the appearance of acne and prevent future breakouts.

16 services15 patients

Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm 11307

This procedure involves the careful removal of a skin growth between 1.1 to 2.0 cm in size. The growth could be located on the scalp, neck, hands, or feet. The process is done using a sharp instrument to shave off the growth, promoting healthier skin.

13 services13 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.

13 services11 patients

Hospital Affiliations CMS Care Compare

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

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61614 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

75/100

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

Scored as part of a group practice

Reported Quality Measures

Biopsy Follow-Up

Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient by the performing physician

73%22 patients3/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

98%10,277 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

32%4,338 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

0%3,471 patients1/55-star benchmark: 88%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 82% · 3,392 patients

Patients tobacco: 74% · 3,392 patients

0%269 patients1/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

69%3,380 patients3/55-star benchmark: 100%

Psoriasis: Tuberculosis (TB) Prevention for Patients with Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier

Percentage of patients whose providers are ensuring active tuberculosis prevention either through yearly negative standard tuberculosis screening tests or are reviewing the patient's history to determine if they have had appropriate management for a recent or…

73%26 patients

Tobacco Use and Help with Quitting Among Adolescents

The percentage of adolescents 12 to 20 years of age with a primary care visit during the measurement year for whom tobacco use status was documented and received help with quitting if identified as a tobacco user

74%645 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 16

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

TAYLOR MARIE WELLS MD

Dermatology