Individual provider Active NPI

Jason Min So, MD

  • Retina Specialist (Ophthalmology) Physician
  • Mishawaka, IN
National Provider Identifier
1801282249
Registry record updated Oct 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
01085899A Issued in IN
Practice address
303 S Main St Ste 215
Mishawaka, IN 46544-2160
Phone
(574) 291-4000
Fax
(260) 279-3211
NPI assigned
Apr 13, 2015
Last updated
Oct 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 307161 LA
Retina Specialist (Ophthalmology) Physician 207WX0107X 01085899A IN Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 4301503865 MI

Addresses

Primary practice location

303 S Main St Ste 215
Mishawaka, IN 46544-2160

Mailing address

50861 Brownstone Dr
Granger, IN 46530-1355
Phone (574) 291-4000

Other names 1

  • Min Ho So Former name

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
I20210616000182 IN Practitioner - Ophthalmology 9638468622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in New Orleans, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana Retina Center LLCGroup PAC ID 0749677011, 3 clinicians

Practice addresses (Care Compare)

7802 W Jefferson Blvd
Suite a
Fort Wayne, IN 46804-4138
Phone (260) 305-2822

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01085899AINMDRetina Specialist (Ophthalmology) Physician
307161LAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Retina Center LLC Retina Specialist CurrentSince Jun 1, 2024 Accepting new patients

Locations

7802 W Jefferson Blvd
#A
Fort Wayne, IN 46804
Phone (260) 305-2822

Interoperability endpoints

  • Direct secure messaging: jso3143555@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1801282249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50861 BROWNSTONE DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301355",
            "telephone_number": "574-291-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S MAIN ST STE 215",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465442160",
            "telephone_number": "574-291-4000",
            "fax_number": "260-279-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "JASON",
        "middle_name": "MIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "LA",
            "license": "307161",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IN",
            "license": "01085899A",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MI",
            "license": "4301503865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIN",
            "last_name": "SO",
            "middle_name": "HO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.