Individual provider Active NPI

James J. Song, M.D.

  • Ophthalmology Physician
  • Fremont, CA
National Provider Identifier
1245341700
Registry record updated May 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
AO68524 Issued in CA
Practice address
2299 Mowry Ave
Suite 3a
Fremont, CA 94538
Phone
(510) 713-9898
Fax
(510) 280-7279
NPI assigned
Aug 31, 2006
Last updated
May 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X AO68524 CA Primary

Addresses

Primary practice location

2299 Mowry Ave
Suite 3a
Fremont, CA 94538

Mailing address

2299 Mowry Ave
Suite 3a
Fremont, CA 94538-1621
Phone (510) 713-9898

Other identifiers 1

IdentifierTypeStateIssuer
00A685240MedicaidCA

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
I20111221000824 CA Practitioner - Ophthalmology 3072789098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Michigan Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2299 Mowry Ave
Fremont, CA 94538-1621

Merit-based Incentive Payment System (MIPS)

Final score
99.49 of 100Reported as individual
Quality
88.99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO68524CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James J Song MD Professional Corp Ophthalmology CurrentSince Sep 13, 2011 Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
Washington Township Hospital District Past Accepting new patients
Dameron Hospital Association Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Eden Medical Center/San Leandro Hospital Campus Past Accepting new patients

Locations

1999 Mowry Ave
Ste 2F
Fremont, CA 94538
Phone (510) 713-9898

2299 Mowry Ave
Ste 3A
Fremont, CA 94538
Phone (510) 585-5233

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1245341700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 MOWRY AVE",
            "address_2": "SUITE 3A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381621",
            "telephone_number": "510-713-9898",
            "fax_number": "510-280-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 MOWRY AVE",
            "address_2": "SUITE 3A",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-713-9898",
            "fax_number": "510-280-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JAMES",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "AO68524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A685240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.