NPIMap

Individual provider Active NPI

Rui Song, MD

  • Nephrology Physician
  • Willow Grove, PA
National Provider Identifier
1033761952
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD484984 Issued in PA
Practice address
735 Fitzwatertown Rd Ste 1
Willow Grove, PA 19090-1338
Phone
(215) 657-2012
Fax
(215) 657-2012
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD484984 PA Primary

Addresses

Primary practice location

735 Fitzwatertown Rd Ste 1
Willow Grove, PA 19090-1338

Mailing address

735 Fitzwatertown Rd Ste 1
Willow Grove, PA 19090-1338
Phone (215) 657-2012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904004577 PA Practitioner - Internal MedicinePractitioner - Nephrology 3577891118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hypertension Nephrology Associates PCGroup PAC ID 6103809967, 17 clinicians

Practice addresses (Care Compare)

735 Fitzwatertown Rd
Suite 1
Willow Grove, PA 19090-1338
Phone (215) 657-2012

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD484984PAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hypertension Nephrology Associates, PC Nephrology CurrentSince Aug 1, 2024 Accepting new patients

Locations

735 Fitzwatertown Rd
Ste 1
Willow Grove, PA 19090
Phone (215) 657-2012

Interoperability endpoints

  • Direct secure messaging: rsong3517759@direct.trinity-health.org

Organizations & group practices 1

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1033761952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 FITZWATERTOWN RD STE 1",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901338",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 FITZWATERTOWN RD STE 1",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901338",
            "telephone_number": "215-657-2012",
            "fax_number": "215-657-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "RUI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD484984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.