Ein Gun Song, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD60604630 Issued in WA

Practice address

15906 Mill Creek Blvd Ste 105
Mill Creek, WA 98012-1797

Phone

(425) 385-2009

NPI assigned

Mar 29, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jamess@frontierdermpartners.emadirect.md

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.

• Silver Falls Dermatology, LLC

  • Dermatology Physician
  • Salem, OR
  • NPI 1134375421

  WA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1548536972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD STE 105",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-385-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15906 MILL CREEK BLVD STE 105",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121797",
            "telephone_number": "425-385-2009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908225201",
            "country_code": "US",
            "telephone_number": "562-826-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "EIN",
        "middle_name": "GUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A127623",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "60604630",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD60604630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Smith
• Megen Smith, LMT
• Cherina Smithson, LMP
• Laura Renee Sobieck, D.O.
• Yekatrina Solop, LMP
• Sonu Lamba and Paul S Kahlon, PS
• Kathryn Sordahl, LMT
• Gabrielle Soucy-Kochelayev, D.C.
• Sound Autism Partners LLC
• Hannah C Spears, ARNP

• MOHS-Micrographic Surgery Physician in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• MOHS-Micrographic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.