Individual provider Active NPI

Maria Song, M.D.

  • Family Medicine Physician
  • Hamburg, NJ
National Provider Identifier
1013216985
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA08855400 Issued in NJ
Practice address
225 Route 23 North
Hamburg, NJ 07419
Phone
(973) 209-1550
Fax
(973) 209-4832
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08855400 NJ Primary

Addresses

Primary practice location

225 Route 23 North
Hamburg, NJ 07419

Mailing address

532 Lafayette Rd
Suite 300
Sparta, NJ 07871-4411
Phone (973) 940-0423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08855400NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Urgent Care, PLLC CurrentSince Sep 14, 2016 Accepting new patients
Highlands Interventional Pain Management LLC Past Accepting new patients
Healing Touch Physical Therapy Center LLC Past Accepting new patients

Locations

26 Court St
Brooklyn, NY 11242
Phone (718) 283-8225

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1013216985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 LAFAYETTE RD",
            "address_2": "SUITE 300",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714411",
            "telephone_number": "973-940-0423",
            "fax_number": "973-940-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ROUTE 23 NORTH",
            "city": "HAMBURG",
            "state": "NJ",
            "postal_code": "07419",
            "telephone_number": "973-209-1550",
            "fax_number": "973-209-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08855400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NJ

Sources for this page

Verify at the official NPI Registry.