Individual provider Active NPI

Hee Young So, M.D

  • Psychiatry Physician
  • Jersey City, NJ
National Provider Identifier
1215080270
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25MA03343700 Issued in NJ
Practice address
395 Grand St
Jersey City, NJ 07302-4238
Phone
(201) 915-2856
NPI assigned
Jan 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25MA03343700 NJ Primary

Addresses

Primary practice location

395 Grand St
Jersey City, NJ 07302-4238

Mailing address

28 Dartmouth Rd
Wayne, NJ 07470-4607
Phone (973) 633-0355

Other identifiers 1

IdentifierTypeStateIssuer
7466803MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20080905000417 NJ Practitioner - Psychiatry 6709952336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valeo Behavioral Health, Inc.Group PAC ID 0042487233, 7 clinicians

Practice addresses (Care Compare)

2911 Route 88
Suite E8
Point Pleasant Boro, NJ 08742-2871
Phone (732) 295-1008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03343700NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valeo Behavioral Health, Inc. CurrentSince Oct 29, 2011 Accepting new patients
St Marys Hospital Psychiatry Past Accepting new patients
Insights Behavioral Health, LLC Psychiatry Past Accepting new patients

Locations

2911 Route 88
Ste E8
Point Pleasant Boro, NJ 08742
Phone (732) 295-1008

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215080270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 DARTMOUTH RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704607",
            "telephone_number": "973-633-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024238",
            "telephone_number": "201-915-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "HEE",
        "middle_name": "YOUNG",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "25MA03343700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7466803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.