Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mathew J. So, MD

Individual provider Diagnostic Radiology Physician · NPI 1215126503

Mathew J. So, MD is a Diagnostic Radiology in Roseville, Minnesota. Graduated from Mayo Medical School in 2007, 19 years ago. Practices with Grand Itasca Clinic and Hospital, a 325-clinician group and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
19
Trained at
Mayo Medical School
Licensed in
MN, WI
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905
Phone: (651) 292-0000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 55169 (MN)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 60597 (WI)

Record details

NPI number1215126503
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 23, 2007
Last updated in NPPESJuly 21, 2021
Certification dateJuly 21, 2021
Mailing address2355 Highway 36 W Ste 100, Roseville, MN 55113-3905

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMAYO MEDICAL SCHOOL
Graduated 2007 (19 years in practice)
Group practice Grand Itasca Clinic And Hospital — 325 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations18 on file with Medicare

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