Individual provider Active NPI

Minwoo Song, MD

  • Neurological Surgery Physician
  • Stanford, CA
National Provider Identifier
1215434816
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A166117 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Apr 10, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A166117 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Other practice location 1

300 Hillmont Ave
Ventura, CA 93003-1651
Phone (805) 652-6000

Other practice location 2

300 Hillmont Ave Ste 401
Ventura, CA 93003-1651
Phone (805) 652-6201

Other practice location 3

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address minwoo.song@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250515002166 CA Practitioner - Neurosurgery 9830617646 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Loma Linda University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of VenturaGroup PAC ID 7911810171, 340 clinicians
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Hillmont Ave
Ventura, CA 93003-1651

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion107
Laminectomy or laminotomy (partial removal of spine bones)43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166117CAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura Current Accepting new patients
County of Ventura CurrentSince Jun 16, 2025 Accepting new patients
Stanford Health Care CurrentSince Jul 1, 2025 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jul 1, 2025 Accepting new patients
Stanford Health Care Neurological Surgery CurrentSince Jul 1, 2025 Accepting new patients
County of Ventura CurrentSince Jun 16, 2025 Accepting new patients

Locations

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

300 Hillmont Ave
Bldg 340
Ventura, CA 93003
Phone (805) 652-6100

800 S Victoria Ave
#L4640
Ventura, CA 93009

300 Hillmont Ave
Ste 401
Ventura, CA 93003
Phone (805) 648-9830

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

Interoperability endpoints

  • Direct secure messaging: msong63696@direct.llu.edu

Organizations & group practices 6

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 8

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1215434816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hillmont Ave",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031651",
            "country_code": "US",
            "telephone_number": "805-652-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Hillmont Ave Ste 401",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031651",
            "country_code": "US",
            "telephone_number": "805-652-6201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "MINWOO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A166117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "minwoo.song@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave Ste 401",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.