Active NPI
Suzette J. Song, M.D.
- Orthopaedic Surgery Physician
- York, PA
National Provider Identifier
1396742409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MD058519L
- Practice address
- 1855 Powder Mill Rd
York, PA 17402-4723 - Phone
- (717) 848-4800
- Fax
- (717) 741-9867
- NPI assigned
- Jul 5, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | MD058519L | PA | |
| Orthopaedic Surgery Physician | 207X00000X | MD058519L | PA | Primary |
Addresses
Primary practice location
1855 Powder Mill Rd
York, PA 17402-4723
Mailing address
2864 Deer Chase LN
York, PA 17403-9584
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 |
|---|---|---|---|
| MD058519L | PA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1396742409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 DEER CHASE LN",
"city": "YORK",
"state": "PA",
"postal_code": "174039584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1855 POWDER MILL RD",
"city": "YORK",
"state": "PA",
"postal_code": "174024723",
"telephone_number": "717-848-4800",
"fax_number": "717-741-9867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "SUZETTE",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-05",
"last_updated": "2023-04-26",
"certification_date": "2023-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0004X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
"state": "PA",
"license": "MD058519L",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MD058519L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.