Chung Yong Song, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

VUT005241 Issued in NY

Practice address

901 Sixth Avenue
Herald Square Optometric Associates PC
New York City, NY 10001

Phone

(212) 967-4177

Fax

(212) 967-2101

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: csong839257@nychhc.direct-ci.com

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.

• Herald Square Optometric Associates, P.C.

  • Optometrist
  • West Nyack, NY
  • NPI 1588939185
  NPD (past)
• State of New York Comptrollers Office

  dba Suny College of Optometry/University Eye Center

  • Optometrist
  • New York, NY
  • NPI 1407829856
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1588637987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 ECHO HILL PATH",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "10598",
            "telephone_number": "914-962-7455",
            "fax_number": "212-967-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SIXTH AVENUE",
            "address_2": "HERALD SQUARE OPTOMETRIC ASSOCIATES PC",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-967-4177",
            "fax_number": "212-967-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "CHUNG",
        "middle_name": "YONG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT005241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIC LICENSE",
            "identifier": "VUT005241",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tushar Shukla
• Saima Haleem Siddiqui, M.D.
• Alice Jo Siegel, MD
• Chong Yu Edwin SNG, MBBS
• Zaniyah Kailanii Solis-Fearon, PSYCHOTHERAPY
• Carol Spero, LCSW
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic
• Hannah Murray Starobin, LCSW-R
• Michele Lynn Stead, PHYSICIAN ASSISTANT
• Jennifer V Stern, RPA

• Optometrist in New York City, NY
• Providers in New York City, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.