Individual provider Active NPI

Angela Anqi Song

  • Psychiatry Physician
  • San Jose, CA
National Provider Identifier
1003493222
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A183946 Issued in CA
Practice address
250 Hospital Pkwy
San Jose, CA 95119-1103
Phone
(408) 972-3000
NPI assigned
Mar 24, 2021
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A183946 CA Primary

Addresses

Primary practice location

250 Hospital Pkwy
San Jose, CA 95119-1103

Mailing address

6620 Via del Oro
San Jose, CA 95119-1452
Phone (408) 972-3095

Other practice location 1

160 E Virginia St Ste 280
San Jose, CA 95112-5817
Phone (214) 516-1893

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717003655 CA Practitioner - Psychiatry 6507247574 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Nov 15, 2024 Accepting new patients
Momentum for Health Current Accepting new patients
Momentum for Health CurrentSince Jul 5, 2023 Accepting new patients
County of Santa Clara CurrentSince Nov 15, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Nov 15, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
Momentum for Health CurrentSince Jul 5, 2023 Accepting new patients
County of Santa Clara CurrentSince Nov 15, 2024 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1922 The Alameda
Ste 316
San Jose, CA 95126
Phone (408) 637-0341

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

2001 The Alameda
San Jose, CA 95126
Phone (408) 938-6750

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1003493222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 VIA DEL ORO",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191452",
            "telephone_number": "408-972-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PKWY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191103",
            "telephone_number": "408-972-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 E Virginia St Ste 280",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951125817",
            "country_code": "US",
            "telephone_number": "214-516-1893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANGELA",
        "middle_name": "ANQI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A183946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.