Dr Douglas Mark Soderberg, MD - Medicare Obstetrics & Gynecology in Minneapolis, MN

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Dr Douglas Mark Soderberg, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Minneapolis, Minnesota. His current practice location is 5415 Queen Ave S, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at (612) 963-1367.

Dr Douglas Mark Soderberg is licensed to practice in Minnesota (license number 26672) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1215997952.

Contact Information

Dr Douglas Mark Soderberg, MD
5415 Queen Ave S,
Minneapolis, MN 55410-2530
(612) 963-1367
(612) 677-3324

Map and Direction




Physician's Profile

Full NameDr Douglas Mark Soderberg
GenderMale
SpecialityObstetrics & Gynecology
Location5415 Queen Ave S, Minneapolis, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1215997952
  • Provider Enumeration Date: 03/25/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 1557358066
  • Enrollment ID: I20040427001347

Medical Identifiers

Medical identifiers for Dr Douglas Mark Soderberg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215997952NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207V00000XObstetrics & Gynecology 26672 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Douglas Mark Soderberg allows following entities to bill medicare on his behalf.
Entity NameFairview Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461
Entity NameAstera Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134305162
PECOS PAC ID: 2961395272
Enrollment ID: O20040202001082
Entity NameCounty Of Meeker
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083221816
PECOS PAC ID: 0840109740
Enrollment ID: O20040216000811
Entity NameAstera Health
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1477545333
PECOS PAC ID: 2961395272
Enrollment ID: O20060504000722
Entity NameCarris Health Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598236408
PECOS PAC ID: 7012274228
Enrollment ID: O20190503001162
Entity NameCentracare Clinic Southwest Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174106264
PECOS PAC ID: 8426457946
Enrollment ID: O20210602002802

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Douglas Mark Soderberg is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Douglas Mark Soderberg, MD
5415 Queen Ave S,
Minneapolis, MN 55410-2530

Ph: (612) 963-1367		Dr Douglas Mark Soderberg, MD
5415 Queen Ave S,
Minneapolis, MN 55410-2530

Ph: (612) 963-1367

Reviews and Comments


Obstetrics & Gynecology Doctors in Minneapolis, MN

David Charles Nagel, MD
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Phone: 612-672-2450    
Jessica L Nyholm, M.D.
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Practice Location: 606 24th Ave S, Suite 400, Minneapolis, MN 55454
Phone: 612-273-2223    
Mr. Clifton O Brock,
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Practice Location: 902 E 26th St Ste 1700, Minneapolis, MN 55404
Phone: 612-863-4502    
John W Hering, MD
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Phone: 612-371-1600    Fax: 612-371-1732
Marilyn Susan Joseph, MD
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Phone: 612-625-5187    Fax: 612-625-0902
Dr. Jennifer Martha Mckeand, MD MS
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Practice Location: 121 South 8th St Suite 600, Womens Health Consultants, Minneapolis, MN 55402
Phone: 612-333-4822    Fax: 612-333-3108
Dr. Amanda Leigh Boozalis, MD
Obstetrics & Gynecology
Medicare: Medicare Enrolled
Practice Location: 3270 W Lake St, Minneapolis, MN 55416
Phone: 612-775-1800    Fax: 612-775-1805

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.