Jisoo Song, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618003230 Issued in VA

Practice address

709 Pine St
Herndon, VA 20170-4604

Phone

(703) 471-7810

Fax

(703) 471-6549

NPI assigned

Mar 3, 2023

Last updated

Nov 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Optometry

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Virginia, PLLCGroup PAC ID 0143448456, 133 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Falls Church, VA
  • NPI 1710343744

  DC

  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Virginia PLLC

  dba MyEyeDr

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment NPD (past)
• Myeyedr Optometry of Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • McLean, VA
  • NPI 1447628284
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD
• National Vision Inc

  dba America's Best Contacts & Eyeglasses

  • Optometrist
  • Pembroke Pines, FL
  • NPI 1538891684
  NPD (past)

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1407556921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 PINE ST",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704604",
            "telephone_number": "703-471-7810",
            "fax_number": "703-471-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JISOO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-03",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003230",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malaika Shahzadi Sohail, DDS
• Joan H Sok, PHARM.D.
• Solaire Vision Herndon, LLC (Solaire Vision)
• Maria Soldatenkov, BCBA
• Soleo Health Inc.
• Theresa M. Soto, MD
• Yelena Soules, DDS
• Fatma Esra Soydan, L.AC.
• Susan Kim Spar, DPT
• Sparkle Dental, PLLC

• Optometrist in Herndon, VA
• Providers in Herndon, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.