Jiyoun Song

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

431104 Issued in NY

Practice address

15408 Northern Blvd
#2K
Flushing, NY 11354-5040

Phone

(718) 445-0200

NPI assigned

Mar 21, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Beacon Health Medical PCGroup PAC ID 1658804760, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HHFGDD/Endpoint/HHFGDD
• FHIR API: https://fhir4.healow.com/fhir/r4/CHFGBA/Endpoint/CHFGBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beacon Health Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1679393052
  Medicare reassignment Care Compare group NPD
• Parcare Community Health Network Inc

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1730454083
  Medicare reassignment NPD
• Park Avenue Pediatrics, P.C.

  • Pediatrics Physician
  • Spring Valley, NY
  • NPI 1699969543
  Medicare reassignment NPD
• Parcare Community Health Network Inc

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1942795943
  NPD
• Ilyagu Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1730859935
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1003347253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15408 NORTHERN BLVD",
            "address_2": "#2K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545040",
            "telephone_number": "718-445-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15408 NORTHERN BLVD",
            "address_2": "#2K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545040",
            "telephone_number": "718-445-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JIYOUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "694059",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ho Yoon Song
• Hongyan Song
• Inhyeok Song, PT, DPT, LAC
• Jiannan Song, MD, PHD
• Jin Song
• Jung Eun Song, PHARMD
• Justin Song, DO
• Kristin Ohyoun Song, DDS
• Seung Yeon Song, L.AC
• Shuhua Song, M.B.

• Acute Care Nurse Practitioner in Flushing, NY
• Providers in Flushing, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.