Individual provider Active NPI

James Y Song, M.D.

  • Neurology Physician
  • Kirkland, WA
National Provider Identifier
1639254519
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD00038370 Issued in WA
Practice address
13107 121St Way NE
Kirkland, WA 98034-3051
Phone
(425) 899-6200
Fax
(425) 899-6220
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD00038370 WA Primary

Addresses

Primary practice location

13107 121St Way NE
Kirkland, WA 98034-3051

Mailing address

13107 121St Way NE
Kirkland, WA 98034-3051
Phone (425) 899-6200

Other identifiers 1

IdentifierTypeStateIssuer
1110162MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070625000302 WA Practitioner - Neurology 1850490335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Washington University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Jun 1, 2016 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 1, 2016 Accepting new patients
King County Public Hospital District No 2 CurrentSince Apr 1, 2016 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1600 116th Ave NE
Ste 304
Bellevue, WA 98004
Phone (425) 453-7888

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1600 116th Ave NE
Ste 302
Bellevue, WA 98004
Phone (206) 455-5440

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

Organizations & group practices 5

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 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1639254519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13107 121ST WAY NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-899-6200",
            "fax_number": "425-899-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13107 121ST WAY NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-899-6200",
            "fax_number": "425-899-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JAMES",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD00038370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110162",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.