Individual provider Active NPI

David H Song, MD

  • Plastic and Reconstructive Surgery Physician
  • Washington, DC
National Provider Identifier
1043375884
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
036101706 Issued in IL
Practice address
3800 Reservoir Rd NW
PHC Building, First Floor
Washington, DC 20007-2113
Phone
(202) 444-8751
Fax
(202) 444-7204
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 036101706 IL Primary
Plastic and Reconstructive Surgery Physician 2086S0122X MD044788 DC

Addresses

Primary practice location

3800 Reservoir Rd NW
PHC Building, First Floor
Washington, DC 20007-2113

Mailing address

3800 Reservoir Rd NW
PHC Building, First Floor
Washington, DC 20007-2113
Phone (202) 444-8751

Other identifiers 1

IdentifierTypeStateIssuer
036101706MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20170330000139 DC Practitioner - Plastic and Reconstructive Surgery 5496724619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2019 Accepting new patients
MGMC, LLC CurrentSince Feb 9, 2017 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 9, 2017 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2019 Accepting new patients
Usc Surgeons, Inc. Past Accepting new patients

Locations

3800 Reservoir Rd NW
Bldg First
Washington, DC 20007
Phone (202) 444-1644

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

6862 Elm St
Ste 800
Mc Lean, VA 22101
Phone (703) 663-4740

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1043375884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "PHC BUILDING, FIRST FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-8751",
            "fax_number": "202-444-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "PHC BUILDING, FIRST FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-8751",
            "fax_number": "202-444-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036101706",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "DC",
            "license": "MD044788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101706",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.