NPI Details
Thomas Modad Soeprono, M.D. is a psychiatry psychiatry neurology in Seattle, WA with 16 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. Thomas Modad Soeprono, M.D. NPI is 1245559467. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2010
The provider's business location address is:
1959 NE PACIFIC ST
BOX 356560
SEATTLE, WA
ZIP 98195-001
Phone: (206) 598-6195
The NPI 1245559467 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Psychotherapy with evaluation and management visit, 45 minutes (HCPCS:90836)
- Psychiatric diagnostic evaluation with medical services (HCPCS:90792)
- Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
The enumeration date for this NPI number is 5/27/2010 and was last updated on 8/13/2015.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 2084P0800X | Psychiatry & Neurology | Psychiatry | MD60475121 | WASHINGTON | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1245559467 | MEDICAID | WASHINGTON | |
| 2 | 8940699 | MEDICARE PIN | WASHINGTON | |
