Individual provider Active NPI

Xueling Song, D.O

  • Optometrist
  • Boston, MA
National Provider Identifier
1437535895
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5121 Issued in MA
Practice address
155 Federal St # 150
Boston, MA 02110-1727
Phone
(617) 261-1813
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5121 MA Primary

Addresses

Primary practice location

155 Federal St # 150
Boston, MA 02110-1727

Mailing address

41 Stanley Rd
Waban, MA 02468-2337
Phone (908) 279-4483

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223000080 MA Practitioner - Optometry 0244535698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

663 VFW Pkwy
Chestnut Hill, MA 02467-3656
Phone (617) 552-3443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5121MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Katelyn Song Eye Care LLC Optometrist CurrentSince Apr 1, 2018 Accepting new patients
Luxottica of America Inc Past Accepting new patients
For Eyes Optical Co, Inc Optometrist Past Accepting new patients

Locations

886 Washington St
Boston, MA 02111
Phone (617) 423-9079

663 Vfw Pkwy
Chestnut Hill, MA 02467
Phone (617) 522-3443

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1437535895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 STANLEY RD",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024682337",
            "telephone_number": "908-279-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 FEDERAL ST # 150",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101727",
            "telephone_number": "617-261-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "XUELING",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "5121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.