Individual provider Active NPI

Jeffrey Song

  • Urology Physician
  • Columbus, OH
National Provider Identifier
1780487918
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
57.257829 Issued in OH
Practice address
915 Olentangy River Rd Ste 2000
Columbus, OH 43212-3159
Phone
(614) 293-8155
NPI assigned
Mar 31, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 57.257829 OH Primary

Addresses

Primary practice location

915 Olentangy River Rd Ste 2000
Columbus, OH 43212-3159

Mailing address

915 Olentangy River Rd Ste 2000
Columbus, OH 43212-3159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250819000790 OH Order and Referring Only - UrologyPractitioner - Urology 5496254278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57.257829OHMDUrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1780487918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 2000",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 OLENTANGY RIVER RD STE 2000",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432123159",
            "telephone_number": "614-293-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "57.257829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.