Individual provider Active NPI

Helen Song, O.D.

  • Optometrist
  • Fredericksburg, VA
National Provider Identifier
1417251331
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002011 Issued in VA
Practice address
4710 Spotsylvania Pkwy
Suite 104
Fredericksburg, VA 22407-9433
Phone
(540) 741-2733
NPI assigned
Jan 6, 2011
Last updated
Jan 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002011 VA Primary
Optometrist 152W00000X 27OA00628000 NJ

Addresses

Primary practice location

4710 Spotsylvania Pkwy
Suite 104
Fredericksburg, VA 22407-9433

Mailing address

4710 Spotsylvania Pkwy
Suite 104
Fredericksburg, VA 22407-9433
Phone (540) 741-2733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20110516000742 VA Practitioner - Optometry 9931385523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Eye Care Center, LLCGroup PAC ID 9931238094, 6 clinicians

Practice addresses (Care Compare)

4710 Spotsylvania Pkwy
Suite 104
Fredericksburg, VA 22407-9433
Phone (540) 741-2733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00628000NJMDOptometrist
0618002011VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Eye Care Center, LLC Optometrist CurrentSince Feb 1, 2011 Accepting new patients

Locations

2300 Fall Hill Ave
Ste 509
Fredericksburg, VA 22401

4710 Spotsylvania Pkwy
Fredericksburg, VA 22407
Phone (540) 373-7133

4710 Spotsylvania Pkwy
Ste 104
Fredericksburg, VA 22407
Phone (540) 741-2733

Interoperability endpoints

  • Direct secure messaging: hsong13250@marywashingtonhealthcare.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1417251331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 SPOTSYLVANIA PKWY",
            "address_2": "SUITE 104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079433",
            "telephone_number": "540-741-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 SPOTSYLVANIA PKWY",
            "address_2": "SUITE 104",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079433",
            "telephone_number": "540-741-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002011",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00628000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.