Individual provider Active NPI

Annie Song, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1073978334
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
1014811 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3096
Phone
(617) 573-3380
NPI assigned
Dec 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 1014811 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3096

Mailing address

243 Charles St
Boston, MA 02114-3096
Phone (617) 573-3380

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230816000959 MA Practitioner - Anesthesiology 2860722881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Johns Hopkins University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1014811MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Anesthesiology CurrentSince Oct 2, 2023 Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

300 Crown Colony Dr
Ste 201
Quincy, MA 02169
Phone (617) 573-3135

Interoperability endpoints

  • Direct secure messaging: song.annie.meei@direct.partners.masshiway.net

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1073978334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143096",
            "telephone_number": "617-573-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "1014811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.