Hanjoon Mike Song, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

057679 Issued in GA

Practice address

3096 Peachtree Industrial Blvd
Duluth, GA 30097

Phone

(770) 495-1477

Fax

(770) 495-1488

NPI assigned

Oct 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Plastic and Reconstructive Surgery

Education

Emory University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prima Center for Plastic Surgery PCGroup PAC ID 6608949185, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Duluth Hospital, Duluth, GA, CCN 110252

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prima Center for Plastic Surgery PC

  • Specialist
  • Duluth, GA
  • NPI 1114065935
  Medicare reassignment Care Compare group NPD
• Prima Ambulatory Surgical Services

  • Ambulatory Surgical Clinic/Center
  • Duluth, GA
  • NPI 1740528934
  NPD

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

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Duluth, GA
  • NPI 1790715381
  Care Compare affiliation

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1063502375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3096 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-495-1477",
            "fax_number": "770-495-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3096 PEACHTREE INDUSTRIAL BLVD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-495-1477",
            "fax_number": "770-495-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "HANJOON",
        "middle_name": "MIKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "057679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762679427B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Calvin So
• Ruth Sok
• Solstice Mental Health Treatment
• Steven Mark Sommer, D.C.
• Chelsea Song, RPH
• Joseph Song, MA, MD
• Minsuk Song, DPT
• Samuel H Song, M.D.
• Sool Kee Song, MD
• Yeohan Song, MD

• Plastic Surgery Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.