Jinsup Song, DPM PHD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC004393L Issued in PA

Practice address

148 N 8TH St
Philadelphia, PA 19107-2496

Phone

(215) 777-5808

Fax

(215) 777-5825

NPI assigned

Sep 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 18

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Temple University School of Podiatric Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Temple University of the Commonwealth System of Higher EducationGroup PAC ID 2961314299, 12 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Temple University of the Commonwealth System of Higher Education

  • Podiatrist
  • Philadelphia, PA
  • NPI 1265446983
  Medicare reassignment Care Compare group NPD
• Temple University of the Commonwealth System of Higher Education

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1386646891
  NPD (past)
• Temple University of the Commonwealth System of Higher Education

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1841268604
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1295721777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE PO BOX 22433",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100872433",
            "telephone_number": "215-777-5808",
            "fax_number": "215-777-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 N 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191072496",
            "telephone_number": "215-777-5808",
            "fax_number": "215-777-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JINSUP",
        "name_prefix": "Dr.",
        "credential": "DPM PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC004393L",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC004393L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018076090003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ MEDICAL ASSISTANCE",
            "identifier": "8259607",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN PPO",
            "identifier": "893038",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "1125735",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "231365971",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1807609",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2665731",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN HMO",
            "identifier": "0499950000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE",
            "identifier": "231365971071",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF PA",
            "identifier": "S0819326",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "231365971",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDER HEALTH / BRAVO",
            "identifier": "9231",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTER-CITY",
            "identifier": "H19826",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2353876",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "28824",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480030054",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "3Y2326",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA HEALTH ASSURANCE",
            "identifier": "435767",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Song
• Eunbee Song
• Faith Song
• Jae Won Song, M.D.
• Jenny Hee Song, PA-C
• Joy Song
• Michael W Song, MD
• Michelle Song, LAPC, MS.ED
• Naomi S Song, CRNA
• Samuel Song

• Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.