Jimmy Song, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10535 Park Meadows Blvd Ste 301
Lone Tree, CO 80124-8456

Phone

(303) 662-8250

NPI assigned

Sep 12, 2024

Last updated

Sep 12, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Gastroenterology Associates, PLLCGroup PAC ID 5991797532, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16409/brand/1/csg/1/fhir/r4

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.

• Rocky Mountain Gastroenterology Associates, PLLC

  • Gastroenterology Physician
  • Lakewood, CO
  • NPI 1669414272
  Medicare reassignment Care Compare group
• Colorado Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Lone Tree, CO
  • NPI 1467745570
  Medicare reassignment
• Colorado Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Colorado Springs, CO
  • NPI 1255728861
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Portercare Adventist Health System

  dba AdventHealth West Littleton ER

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1548800154
  Care Compare affiliation
• Portercare Adventist Health System

  dba Adventhealth Littleton

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1689688988
  Care Compare affiliation
• Portercare Adventist Health System

  dba South Denver Heart Center

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1720628332
  Care Compare affiliation

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1689400848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 301",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248456",
            "telephone_number": "303-662-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 PARK MEADOWS BLVD STE 301",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801248456",
            "telephone_number": "303-662-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JIMMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofi Research, LLC (Institute of Esophageal and Reflux Surgery)
• John Chris Sohayda, MD
• Somnia Sleep Wellness, Inc
• Katrina Sondermann, MSN, RN
• Alexandria Song
• Kevin Kraft Song, DO
• D. Maxine Sonnenberg, D.C.
• Lisa K Sorensen, ANP
• Neil Sorokin, PSYCHOLOGIST
• South Denver Acute Surgery PC

• Physician Assistant in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.