Active NPI
Sang Song, MD
- Clinical Pathology Physician
- Bristol, PA
National Provider Identifier
1265471965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology Physician
- License
- MD03172L
- Practice address
- 501 Bath Rd
Bristol, PA 19007-3101 - Phone
- (215) 785-9200
- Fax
- (215) 785-9039
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD03172L | PA | |
| Clinical Pathology Physician | 207ZC0006X | MD03172L | PA | Primary |
Addresses
Primary practice location
501 Bath Rd
Bristol, PA 19007-3101
Mailing address
501 Bath Rd
Bristol, PA 19007-3101
Phone (215) 785-9200
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0023022000 | Other | PA | IBC |
| 34005B | Other | PA | KEYSTONE MERCY |
| 000953068 0003 | Medicaid | PA | |
| 141292 | Other | PA | HIGHMARK BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD03172L | PA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203897600000",
"number": "1265471965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 BATH RD",
"city": "BRISTOL",
"state": "PA",
"postal_code": "190073101",
"telephone_number": "215-785-9200",
"fax_number": "215-785-9039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 BATH RD",
"city": "BRISTOL",
"state": "PA",
"postal_code": "190073101",
"telephone_number": "215-785-9200",
"fax_number": "215-785-9039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "SANG",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2008-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PA",
"license": "MD03172L",
"primary": false
},
{
"code": "207ZC0006X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology",
"state": "PA",
"license": "MD03172L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "0023022000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "34005B",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000953068 0003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "141292",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.