Individual provider Active NPI

Leonard Kyungsup Song, DO

  • Hospitalist Physician
  • Indianapolis, IN
National Provider Identifier
1689137804
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
02009018A Issued in IN
Practice address
8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone
(317) 802-2000
Fax
(317) 802-2050
NPI assigned
Apr 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11020473A IN
Hospitalist Physician 208M00000X 02009018A IN Primary

Addresses

Primary practice location

8450 Northwest Blvd
Indianapolis, IN 46278-1381

Mailing address

8450 Northwest Blvd
Indianapolis, IN 46278-1381
Phone (317) 802-2000

Other practice location 1

1701 Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-8776

Other practice location 2

1120 W Michigan St # Cl630
Indianapolis, IN 46202-5209
Phone (317) 278-2689

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsong@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20251205000372 IN Practitioner - Internal Medicine 8729312111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 N Shadeland Ave
Indianapolis, IN 46219-4959

8450 Northwest Blvd
Indianapolis, IN 46278-1381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11020473AINMDInternal Medicine Physician
02009018AINMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1689137804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 NORTHWEST BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781381",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 NORTHWEST BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781381",
            "telephone_number": "317-802-2000",
            "fax_number": "317-802-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "317-962-8776",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 W Michigan St # Cl630",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025209",
            "country_code": "US",
            "telephone_number": "317-278-2689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "LEONARD",
        "middle_name": "KYUNGSUP",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11020473A",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "02009018A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsong@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.