Kimberly Ingram Soderberg (NPI# 1386786697, PAC ID# 2365538113) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1386786697 |
| PAC ID by PECOS | 2365538113 |
| Professional Enrollment ID | I20071010000215 |
| Full Name | Kimberly Ingram Soderberg |
| Organization Legal Name | COASTAL DERMATOLOGY P.C. |
| Address |
3176 Holland Rd Suite 103 Virginia Beach VA 23453-2637 |
| Phone Number | 7573687546 |
| Gender | F |
| Medical School | MEDICAL COLLEGE OF VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2003 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 1153450473 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490119 | SENTARA PRINCESS ANNE HOSPITAL |
| 490007 | SENTARA NORFOLK GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3176 Holland Rd, Suite 103, Virginia Beach, VA 23453-2637 | 7573687546 | COASTAL DERMATOLOGY P.C. |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 74% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 98% | |
| MIPS_EC_265_overall | Biopsy Follow-Up | 57% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 85% | |
| MIPS_EC_431_overall | Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 45% |
| Organization Legal Name | COASTAL DERMATOLOGY P.C. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meredith B Huffman | Physician Assistant | Coastal Dermatology P.C. | 3176 Holland Rd, Suite 103, Virginia Beach, VA 23453-2637 |
| Taylor R Watrous | Physician Assistant | Coastal Dermatology P.C. | 3176 Holland Rd, Suite 103, Virginia Beach, VA 23453-2637 |
| Street Address |
3176 HOLLAND RD SUITE 103 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip | 23453-2637 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meredith B Huffman | Physician Assistant | Coastal Dermatology P.C. | 3176 Holland Rd, Suite 103, Virginia Beach, VA 23453-2637 |
| Taylor R Watrous | Physician Assistant | Coastal Dermatology P.C. | 3176 Holland Rd, Suite 103, Virginia Beach, VA 23453-2637 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sandra J Wasko | Physical Therapy | Glasson Sports Medicine PC | 3296 Dam Neck Rd, Virginia Beach, VA 23453-2614 |
| Sandra E Glasson | Orthopedic Surgery | Glasson Sports Medicine PC | 3296 Dam Neck Rd, Virginia Beach, VA 23453-2614 |
| Wendy Anne Calender-howlett | Nurse Practitioner | City of Virginia Beach | 3143 Magic Hollow Blvd, Suite 200, Virginia Beach, VA 23453-3077 |
| Leslie J Kryzanowski | Psychiatry | City of Virginia Beach | 3143 Magic Hollow Blvd, Suite 200, Virginia Beach, VA 23453-3077 |
| Stephanie Allyn Harrell | Clinical Social Worker | City of Virginia Beach | 3143 Magic Hollow Blvd, Suite 200, Virginia Beach, VA 23453-3077 |
| Sreeja Kadakkal | Psychiatry | City of Virginia Beach | 3143 Magic Hollow Blvd, Virginia Beach, VA 23453-3077 |
| Gautam D Desai | Family Medicine | 2020 S Independence Blvd, Suite 3, Virginia Beach, VA 23453-4776 | |
| Jitendra M Patel | Internal Medicine | 2020 S Independence Blvd, Virginia Beach, VA 23453-4776 | |
| Edward F Roberts | Obstetrics/gynecology | Commonwealth Women's Healthcare, Inc. | 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 |
| Michael Spruiell | Obstetrics/gynecology | Commonwealth Women's Healthcare, Inc. | 2020 S Independence Blvd, Suite 5, Virginia Beach, VA 23453-4776 |
| Find all physicians in zip 23453 | |||
| City | VIRGINIA BEACH |
| Zip Code | 23453 |
| Specialty | DERMATOLOGY |
| City + Specialty | VIRGINIA BEACH + DERMATOLOGY |
Please comment or provide details below to improve the information on Kimberly Ingram Soderberg.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.