Individual provider Active NPI

Seo Young Son, NP-C

  • Family Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1548790306
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00734000 Issued in NJ
Practice address
200 Grand Ave Ste 203
Englewood, NJ 07631-4363
Phone
(201) 944-3115
NPI assigned
Jun 14, 2017
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00734000 NJ Primary

Addresses

Primary practice location

200 Grand Ave Ste 203
Englewood, NJ 07631-4363

Mailing address

200 Grand Ave Ste 203
Englewood, NJ 07631-4363
Phone (201) 944-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819003937 NJ Practitioner - Nurse Practitioner 3870919954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

9020 Wall St
North Bergen, NJ 07047-6011
Phone (201) 861-4040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00734000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Aug 15, 2020 Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

200 Grand Ave
Ste 203
Englewood, NJ 07631
Phone (201) 710-2768

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

9020 Wall St
North Bergen, NJ 07047
Phone (201) 809-2900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJFCAA/Endpoint/FJFCAA

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.

Hospital & facility affiliations 1

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1548790306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 203",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363",
            "telephone_number": "201-944-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 203",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363",
            "telephone_number": "201-944-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "SEO YOUNG",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00734000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.