Jason Min So, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

4301503865 Issued in MI

Practice address

2848 Niles Rd
Saint Joseph, MI 49085-3352

Phone

(269) 428-3300

NPI assigned

Apr 13, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Min Ho So Former name

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

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)

Hospital & facility affiliations

• St Joseph Health System, LLC Hospital, Fort Wayne, IN, CCN 150047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Indiana Retina Center LLC

  • Retina Specialist (Ophthalmology) Physician
  • Fort Wayne, IN
  • NPI 1518609429
  Medicare reassignment Care Compare group NPD

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

• St. Joseph Health System, LLC

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1023060472
  Care Compare affiliation

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1801282249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853352",
            "telephone_number": "269-428-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853352",
            "telephone_number": "269-428-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Longmeadow Village Dr",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491207808",
            "country_code": "US",
            "telephone_number": "269-684-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3550 Park Pl W Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465453573",
            "country_code": "US",
            "telephone_number": "574-222-1403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SO",
        "first_name": "JASON",
        "middle_name": "MIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "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": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MI",
            "license": "4301503865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIN",
            "last_name": "SO",
            "middle_name": "HO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kortney Zoe Smith, DO
• Lowell D Smith, M.D.
• Ethan Michael Snider, DO
• Rickey L Snipes, M.D.
• Daniel H Snyder, MD
• Daniel G. Sohn, M.D.
• Jennifer Sommer
• Oliver Chambers Songlingco, M.D.
• John Sordyl IV, CRNA
• Ryan Sosh, MD

• Retina Specialist (Ophthalmology) Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Retina Specialist (Ophthalmology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.