Richard Song, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00004160 Issued in WA

Practice address

17 148TH Ave SE
Ste a
Bellevue, WA 98007

Phone

(425) 644-6478

Fax

(425) 644-6476

NPI assigned

Oct 26, 2006

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

Other names 1

• Dr. Jeong-Hun Song Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dr. J. Song, Optometrist, Inc.

  • Optometrist
  • Bellevue, WA
  • NPI 1336320068
  Medicare reassignment
• National Optometry Steven Kasinof and 17 Associates Optometrists

  • Optometrist
  • Virginia Beach, VA
  • NPI 1154406353
  NPD (past)
• National Optometry Steven Kasinof and 17 Associates Optometrists

  • Optometrist
  • Virginia Beach, VA
  • NPI 1275947707
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1811072028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 394",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980090394",
            "telephone_number": "425-644-6478",
            "fax_number": "425-644-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 148TH AVE SE",
            "address_2": "STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98007",
            "telephone_number": "425-644-6478",
            "fax_number": "425-644-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEONG-HUN",
            "last_name": "SONG",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amos Song, M.D.
• Clara H Song, D.D.S.
• Jennifer Song, DO
• Jie Song, LMT
• Kevin Song, D.D.S.
• Ruoying Song
• Yeasol Song
• Reeti Soni, DMD
• Sonja Merz LMFT PLLC
• Sookyung Jun DMD PLLC

• Optometrist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Optometrist in Washington

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.