Min Soo Song, MD.,CM

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

239085 Issued in MA

Practice address

105 Erdman Way
Leominster, MA 01453-1805

Phone

(978) 466-7800

Fax

(978) 466-9333

NPI assigned

Jul 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Gastroenterology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Worcester Gastroenterology, P.C.Group PAC ID 7113069899, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: songminsoo@nwgastro.ssdirect.aprima.com

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.

• North Worcester Gastroenterology, P.C.

  • Gastroenterology Physician
  • Leominster, MA
  • NPI 1245567049
  Medicare reassignment Care Compare group NPD
• North Worcester Gastroenterology PC

  • Gastroenterology Physician
  • Leominster, MA
  • NPI 1801137492
  NPD

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

• Umass Memorial Healthalliance Clinton Hospital Inc

  • General Acute Care Hospital
  • Leominster, MA
  • NPI 1013995133
  Care Compare affiliation
• Umass Memorial Healthalliance Clinton Hospital Inc

  • Psychiatric Hospital Unit
  • Clinton, MA
  • NPI 1285171934
  Care Compare affiliation
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1053575340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531805",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531805",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "MIN SOO",
        "name_prefix": "Dr.",
        "credential": "MD.,CM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "239085",
            "primary": true
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "NY",
            "license": "248069",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "1053575340",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "498955",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "951278-01",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "98493515",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0442974",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1053575340",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH CARE",
            "identifier": "1053575340",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CARE",
            "identifier": "AA146200",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "001093301",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "1053575340",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082569A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASSACHUSETTS",
            "identifier": "1053575340",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH MEDICAID",
            "identifier": "30208701",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "3523061",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shyla J Sneed
• Agnieszka B Snioch, MD
• Amin K. Soltani, M.D.
• Somnotek, LLC
• Janice Lee Son, M.D.
• Sopheeyah Organization Inc.
• James A. Sorensen, PT
• Source Equipment Company
• Ralph Edgar Spada, M.D., FACP
• Eric Damian Spagnuolo, PA-C

• Gastroenterology Physician in Leominster, MA
• Providers in Leominster, MA by specialty
• Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.