Individual provider Active NPI

Michael Song, MD

  • Anesthesiology Physician
  • Ramsey, NJ
National Provider Identifier
1104925080
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA06850400 Issued in NJ
Practice address
500 N Franklin Tpke
Suite 206
Ramsey, NJ 07446-1177
Phone
(201) 962-7282
Fax
(201) 962-7283
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA06850400 NJ Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA06850400 NJ

Addresses

Primary practice location

500 N Franklin Tpke
Suite 206
Ramsey, NJ 07446-1177

Mailing address

255 W Michigan Ave
P. O. Box 1123
Jackson, MI 49201-2218
Phone (517) 787-6440

Other identifiers 1

IdentifierTypeStateIssuer
01664740MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210908001439 FL Practitioner - Anesthesiology 6901898337 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quiescence Anesthesia LLCGroup PAC ID 2567750359, 8 clinicians
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians

Practice addresses (Care Compare)

10475 Centurion Pkwy N
Suite 201
Jacksonville, FL 32256-5004
Phone (904) 223-3321

9143 Philips Hwy
Suite 500
Jacksonville, FL 32256-1335
Phone (888) 324-7432

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06850400NJMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Anesthesia LLC Anesthesiology CurrentSince Jul 1, 2021 Accepting new patients
Tranquil Anesthesiology LLC Anesthesiology CurrentSince Apr 3, 2025 Accepting new patients
Ironcrest Anesthesia LLC Anesthesiology CurrentSince Jan 1, 2026 Accepting new patients
Orthomed Staffing LLC Anesthesiology CurrentSince Jan 24, 2026 Accepting new patients
Quiescence Anesthesia LLC CurrentSince Jul 12, 2021 Accepting new patients
Overwatch Anesthesia CurrentSince Jan 1, 2023 Accepting new patients
Port Jervis Anesthesiology Associates, PLLC Past Accepting new patients
Ramapo Pain Management & Medical Services, PLLC Past Accepting new patients
Ramapo Anesthesiologists, PC Anesthesiology PastSince Mar 5, 2007 Accepting new patients
New Jersey Pain Consultants PC Past Accepting new patients

Locations

93 N Park Place Blvd
Ste 102
Clearwater, FL 33759
Phone (727) 240-2088

980 Milwaukee Ave
Dunedin, FL 34698
Phone (330) 704-4752

5238 Mason Corbin Ct
Ste 101
Fort Myers, FL 33907
Phone (239) 489-3166

5191 First Coast Tech Pkwy
Fl 1
Jacksonville, FL 32224
Phone (904) 593-5146

9143 Philips Hwy
Ste 500
Jacksonville, FL 32256
Phone (904) 233-0597

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

9726 Touchton Rd
Ste 305
Jacksonville, FL 32246
Phone (904) 686-6020

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

619 SW Baya Dr
Ste 102
Lake City, FL 32025
Phone (386) 361-3400

2207 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-1200

6900 Turkey Lake Rd
Ste 2-5
Orlando, FL 32819
Phone (407) 354-5401

1780 N Mills Ave
Orlando, FL 32803
Phone (407) 426-8484

598 Sterthaus Dr
Ormond Beach, FL 32174
Phone (386) 256-2565

1399 Jenks Ave
Bldg J
Panama City, FL 32401
Phone (850) 532-6303

3505 Progress Ln
Saint Cloud, FL 34769
Phone (407) 348-5175

2010 Fleischmann Rd
Tallahassee, FL 32308
Phone (850) 552-0608

1879 Nightingale Ln
Ste A1
Tavares, FL 32778
Phone (352) 401-1919

15548 W Colonial Dr
Winter Garden, FL 34787
Phone (407) 547-1654

1303 Dantignac St
Ste 2500
Augusta, GA 30901
Phone (706) 722-6900

1468 Montreal Rd
Ste 200
Tucker, GA 30084
Phone (770) 638-1400

Organizations & group practices 10

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1104925080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "address_2": "P. O. BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N FRANKLIN TPKE",
            "address_2": "SUITE 206",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461177",
            "telephone_number": "201-962-7282",
            "fax_number": "201-962-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA06850400",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA06850400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01664740",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramsey, NJ

Sources for this page

Verify at the official NPI Registry.