Mary Song, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA100794 Issued in MA

Practice address

179 Longwood Ave
Boston, MA 02115-5804

Phone

(978) 995-2625

NPI assigned

Jun 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Walk-in MD ClinicGroup PAC ID 5294105185, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

Medicare enrollment (NPD)

Enrolled

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.

• Walk-in MD Clinic

  • Urgent Care Clinic/Center
  • Randolph, MA
  • NPI 1003543398
  Medicare reassignment Care Compare group
• Urgent Care Centers of Central Massachusetts, LLC

  • Urgent Care Clinic/Center
  • Marlborough, MA
  • NPI 1497286280
  Medicare reassignment
• Urgent Care Centers of Central Massachusetts, LLC

  • Urgent Care Clinic/Center
  • Northborough, MA
  • NPI 1417488206
  NPD
• Walk-in MD Clinic

  • Urgent Care Clinic/Center
  • Cohasset, MA
  • NPI 1740146661
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1396589024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "978-995-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "978-995-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA100794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiunn Song
• Jonathan J Song
• Julia Song, MD
• June Song, PA-C
• Margaret Song, CRNA
• Michael Song
• Phillip C Song, M.D.
• Rinn Song, MD
• Seo Ho Song, MD
• Seunghan Song, D.M.D.

• Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.