Jason Jeong Hwan Song, M.D., PH.D

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

123792 Issued in FL

Practice address

2801 17TH St Unit 202
Saint Cloud, FL 34769-4939

Phone

(407) 906-1328

Fax

(866) 425-8143

NPI assigned

Feb 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation

Education

Temple University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Tree Interventional Pain Management PLLCGroup PAC ID 2062771173, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIFHAD/Endpoint/DIFHAD

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.

• Palm Tree Interventional Pain Management, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Saint Cloud, FL
  • NPI 1336682764
  Medicare reassignment Care Compare group NPD Authorized official
• Cardiac Clinic of Sunil M. Kakkar, M.D, P.a

  • Interventional Cardiology Physician
  • Kissimmee, FL
  • NPI 1457319329
  NPD (past)
• The Next Step Counseling Center, LLC

  • Mental Health Counselor
  • Saint Cloud, FL
  • NPI 1932440393
  NPD (past)

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

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1205074002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 17TH ST UNIT 202",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694939",
            "telephone_number": "407-906-1328",
            "fax_number": "866-425-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 17TH ST UNIT 202",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694939",
            "telephone_number": "407-906-1328",
            "fax_number": "866-425-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JASON",
        "middle_name": "JEONG HWAN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME123792",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "FL",
            "license": "ME123792",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "236756",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "123792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015031800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Solace Medical Care SC LLC
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• Ana Laura Soler
• Kristal Marie Soler, M.S., ED.S., LMHC
• Trang Thi Thu Huynh Sookhan
• Maria Alejandra Sosa Velasquez, DO
• Esther Sotomayor
• South Central Florida Dialysis Partners LLC
• Speech Lab Therapy Center LLC

• Pain Medicine Physician in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.