JASON S SO DO NPI 1508078643

NPI Information

  • NPI: 1508078643
  • Provider Name: JASON S SO, DO
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 350 PELLER RD
    LAKE GENEVA, WI
    ZIP 53147
  • Phone: (262) 245-0221

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NPI Details

Jason S So, DO is a family medicine in Lake Geneva, WI with 21 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jason S So, DO NPI is 1508078643. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

350 PELLER RD
LAKE GENEVA, WI
ZIP 53147-543
Phone: (262) 245-0221
Fax: (262) 249-0633

The NPI 1508078643 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.

  • Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99490)
  • Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99487)
  • Established patient home visit, typically 40 minutes (HCPCS:99349)
  • Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a (HCPCS:G0179)
  • Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99489)
  • Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month (HCPCS:99439)
  • Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and (HCPCS:G0180)
  • Advance care planning, first 30 minutes (HCPCS:99497)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Smoking and tobacco use intensive counseling, 4-10 minutes (HCPCS:99406)
  • New patient home visit, typically 75 minutes (HCPCS:99345)
  • Established patient home visit, typically 1 hour (HCPCS:99350)
  • Established patient home visit, typically 25 minutes (HCPCS:99348)
  • Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (HCPCS:G0438)
  • Anticoagulant management of patient taking warfarin (HCPCS:93793)

The enumeration date for this NPI number is 5/3/2007 and was last updated on 8/29/2019.

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
1207Q00000XFamily Medicine036119919ILLINOISNo
2207Q00000XFamily Medicine63015-21WISCONSINYes

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
11508078643OTHERWISCONSINBCBSWI
2SOJASOTHERWISCONSINMERCYCARE INSURANCE
31508078643MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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