Carl W Soderstrom Jr. (NPI# 1053370759, PAC ID# 5496775082) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1053370759 |
| PAC ID by PECOS | 5496775082 |
| Professional Enrollment ID | I20091130000143 |
| Full Name | Carl W Soderstrom Jr. |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Address |
2315 Roosevelt St Clinton IA 52732-2412 |
| Phone Number | 5632423571 |
| Gender | M |
| Graduation Year | 1967 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2062432651 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140064 | ST MARY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2315 Roosevelt St, Clinton, IA 52732-2412 | 5632423571 | SODERSTROM DERMATOLOGY CENTER S C |
| 1800 E 54th St B, Davenport, IA 52807-2852 | 5633447546 | SODERSTROM DERMATOLOGY CENTER S C |
| 60 S Soangetaha Rd, Galesburg, IL 61401-7524 | 3093445777 | SODERSTROM DERMATOLOGY CENTER S C |
| 2100 Jacobssen Dr, Normal, IL 61761-2499 | 3092689980 | SODERSTROM DERMATOLOGY CENTER S C |
| 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 | 3096747546 | SODERSTROM DERMATOLOGY CENTER S C |
| 2200 Marquette Rd, Peru, IL 61354-1547 | 8152247400 | SODERSTROM DERMATOLOGY CENTER S C |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 2% | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 58% | |
| MIPS_EC_138_overall | Melanoma: Coordination of Care | 40% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 97% | |
| MIPS_EC_265_overall | Biopsy Follow-Up | 100% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 83% | |
| MIPS_EC_431_overall | Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling | 80% |
| Organization Legal Name | SODERSTROM DERMATOLOGY CENTER S C |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nour Almardini | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| James M Jeffries Iii | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Stuart H Berryman | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| Carissa L Pardekooper | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Joy M Watson | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Chen Wang | Pathology | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Jennifer G Tomelden | Physician Assistant | Soderstrom Dermatology Center S C | 2200 Marquette Rd, Peru, IL 61354-1547 |
| John E Lomax | Plastic and Reconstructive Surgery | Soderstrom Dermatology Center S C | 4909 N Glen Park Place Rd, Peoria, IL 61614-4676 |
| Michelle L Roth | Physician Assistant | Soderstrom Dermatology Center S C | 60 S Soangetaha Rd, Galesburg, IL 61401-7524 |
| Katherine E Shindelar | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Street Address |
2315 ROOSEVELT ST |
| City | CLINTON |
| State | IA |
| Zip | 52732-2412 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carissa L Pardekooper | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Joy M Watson | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Katherine E Shindelar | Physician Assistant | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Meriner M Pereira | Dermatology | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Michael L Hayes | Dermatology | Soderstrom Dermatology Center S C | 2315 Roosevelt St, Clinton, IA 52732-2412 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan P Connell | Chiropractic | 1485 Main Ave, Clinton, IA 52732-1976 | |
| Donald G Flory | Family Practice | Medical Associates of Clinton Iowa Plc | 2400 Lillian Way, Clinton, IA 52732-2001 |
| Elliot M Galey | Family Medicine | Genesis Health System | 221 Main Ave, Clinton, IA 52732-2241 |
| Richard B Forrest | Chiropractic | Ruden- Forrest Chiropractic PC | 80 23rd Ave N, Clinton, IA 52732-2401 |
| Thea M Ruden | Chiropractic | Ruden- Forrest Chiropractic PC | 80 23rd Ave N, Clinton, IA 52732-2401 |
| Shirley J Haverly Felten | Speech Language Pathologist | Providence Therapy Services LLC | 2320 N 2nd St, Clinton, IA 52732-2434 |
| Cynthia A Winter | Speech Language Pathologist | Providence Therapy Services LLC | 2320 N 2nd St, Clinton, IA 52732-2434 |
| Annette M Stockwell | Chiropractic | 1805 N 2nd St, Burkert Chiropractic Center (bcc), Clinton, IA 52732-2642 | |
| Kenneth D Womboldt Jr. | Chiropractic | 1721 N 2nd St, Clinton, IA 52732-2644 | |
| Stephanie G Holesinger | Nurse Practitioner | City Medical Partners Pa | 600 14th Ave N, Mercy Living Center North, Clinton, IA 52732-2914 |
| Find all physicians in zip 52732 | |||
| City | CLINTON |
| Zip Code | 52732 |
| Specialty | DERMATOLOGY |
| City + Specialty | CLINTON + DERMATOLOGY |
Please comment or provide details below to improve the information on Carl W Soderstrom Jr..
| 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.