Individual provider Active NPI

Ha Jung Song, F.N.P

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1700145083
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19562 Issued in CA
Practice address
757 Westwood PLZ Ste 2146
Los Angeles, CA 90095-8358
Phone
(310) 267-9793
Fax
(310) 267-3783
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19562 CA Primary

Addresses

Primary practice location

757 Westwood PLZ Ste 2146
Los Angeles, CA 90095-8358

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1250 16th St Ste 2340
Santa Monica, CA 90404-1249
Phone (424) 259-8720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161007000732 CA Practitioner - Nurse Practitioner 0244528206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Geffen School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCLA Radiology Medical GroupGroup PAC ID 8921902065, 193 clinicians

Practice addresses (Care Compare)

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19562CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Radiology Medical Group CurrentSince Aug 14, 2016 Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients
UCLA Medical Center Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

757 Westwood Plz
Ste 2146
Los Angeles, CA 90095
Phone (310) 267-9793

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1250 16th St
Ste 2340
Santa Monica, CA 90404
Phone (424) 259-8720

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: hsong48857@direct.uclahealth.org

Organizations & group practices 4

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 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": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1700145083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 2146",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-267-9793",
            "fax_number": "310-267-3783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 16th St Ste 2340",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041249",
            "country_code": "US",
            "telephone_number": "424-259-8720",
            "fax_number": "424-259-6521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "HA JUNG",
        "credential": "F.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "19562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.