Individual provider Active NPI

Weilin Song

  • Ophthalmology Physician
  • Philadelphia, PA
National Provider Identifier
1154070613
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD493728 Issued in PA
Practice address
840 Walnut St Ste 1020
Philadelphia, PA 19107-5180
Phone
(800) 331-6634
NPI assigned
Mar 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD493728 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

840 Walnut St Ste 1020
Philadelphia, PA 19107-5180

Mailing address

840 Walnut St Ste 1020
Philadelphia, PA 19107-5180
Phone (800) 331-6634

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wsong@midatlret.intellechartdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260519000205 PA Practitioner - Ophthalmology 0345690863

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retinovitreous Associates LTDGroup PAC ID 2961485412, 35 clinicians
Wills Eye Ophthalmology Clinic, IncGroup PAC ID 9133025166, 146 clinicians

Practice addresses (Care Compare)

840 Walnut St
Philadelphia, PA 19107-5109
Phone (800) 331-6634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD493728PAMDOphthalmology Physician

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": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1154070613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "800-331-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 WALNUT ST STE 1020",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075180",
            "telephone_number": "800-331-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "WEILIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD493728",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wsong@midatlret.intellechartdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "840 Walnut St Ste 1020",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191075180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.