NPIMap

Individual provider Active NPI

Anjeli Song, MD

  • Neurology Physician
  • Port Matilda, PA
National Provider Identifier
1518586569
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
C4585 Issued in KY
Practice address
132 Abigail LN
Port Matilda, PA 16870-7153
Phone
(814) 272-7100
Fax
(814) 272-6519
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X ME174303 FL
Clinical Neurophysiology Physician 2084N0600X MD490335C PA
Clinical Neurophysiology Physician 2084N0600X C4585 KY
Neurology Physician 2084N0400X C4585 KY Primary

Addresses

Primary practice location

132 Abigail LN
Port Matilda, PA 16870-7153

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (814) 272-7100

Other practice location 1

740 S Limestone
Lexington, KY 40536-0001
Phone (859) 323-5661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY, GA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250919000241 NC Practitioner - Neurology 9537663760 Reassigns benefits to 1 organization
I20250923003306 NY Practitioner - Neurology 9537663760 Reassigns benefits to 2 organizations
I20260316003234 GA Practitioner - Neurology 9537663760 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Boston University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remote Neuromonitoring Physicians PCGroup PAC ID 1355495961, 36 clinicians
Sentient Physicians, P.C.Group PAC ID 2668764333, 37 clinicians

Practice addresses (Care Compare)

216 Halsey Ave
Jericho, NY 11753-1602
Phone (800) 348-4565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C4585KYMDNeurology Physician
ME174303FLMDClinical Neurophysiology Physician
MD490335CPAMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentient Physicians, P.C. Neurology CurrentSince Aug 31, 2025 Accepting new patients
Remote Neuromonitoring Physicians ,PC Neurology CurrentSince Aug 31, 2025 Accepting new patients
Carteret County General Hospital Corporation CurrentSince Jul 29, 2025 Accepting new patients
West Virginia University Medical Corporation Neurology Past Accepting new patients

Locations

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

3 Maryland Farms
Ste 200
Brentwood, TN 37027
Phone (615) 346-8733

Interoperability endpoints

  • Direct secure messaging: asong3030879@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: asong272634@direct-lghealth.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: asong808746@direct.shands.ufl.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1518586569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "814-272-7100",
            "fax_number": "814-272-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LN",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707153",
            "telephone_number": "814-272-7100",
            "fax_number": "814-272-6519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5661",
            "fax_number": "859-323-6411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANJELI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "ME174303",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "PA",
            "license": "MD490335C",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "KY",
            "license": "C4585",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "C4585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.