Sang H Song Sr., MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

208578 Issued in NY

Practice address

740 Veterans Hwy
Suite 203
Hauppauge, NY 11788-2329

Phone

(631) 366-4474

Fax

(631) 366-4473

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Physical Medicine and Rehabilitation

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ivy Medicine, PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hauppauge, NY
  • NPI 1932328168
  Medicare reassignment
• Jr Medical & Diagnostic Servides P.C.

  • Family Medicine Physician
  • Bay Shore, NY
  • NPI 1518139393
  NPD (past)
• Professional Rehab P.T., P.C.

  • Physical Therapy Clinic/Center
  • Medford, NY
  • NPI 1871786327
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1093702425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2711",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117460559",
            "telephone_number": "631-673-1177",
            "fax_number": "631-489-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 VETERANS HWY",
            "address_2": "SUITE 203",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882329",
            "telephone_number": "631-366-4474",
            "fax_number": "631-366-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SANG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "208578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynzie Smith, OTR/L
• Elizabeth Jessica Smyth, PSY.D
• Doreen Sobelman, MA
• Haley Kate Sommer, LMSW
• Hyunna Song, D.M.D.
• Dave Sookhai, RN
• Jayne Elizabeth Sowulewski, CNIM
• Anthony J Spataro, M.D.
• Jaime Patricia Spencer, O.T.R.
• Philip S Spencer, MD

• Physical Medicine & Rehabilitation Physician in Hauppauge, NY
• Providers in Hauppauge, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.