Individual provider Active NPI

Grace Song, MD

  • Family Medicine Physician
  • North Royalton, OH
National Provider Identifier
1891870911
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35082229S Issued in OH
Practice address
10139 Royalton Rd Ste H
North Royalton, OH 44133-4473
Phone
(440) 816-2878
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 35082229S OH Primary

Addresses

Primary practice location

10139 Royalton Rd Ste H
North Royalton, OH 44133-4473

Mailing address

PO Box 638269
Cincinnati, OH 45263-8269
Phone (440) 816-2878

Other identifiers 1

IdentifierTypeStateIssuer
2425807MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gsong@direct.swgeneral.com Southwest General Medical Group Inc

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
I20100310000250 OH Practitioner - Family Practice 0749325116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7171 Royalton Rd
Suite 201
North Royalton, OH 44133-4818
Phone (440) 816-2878

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082229SOHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Southwest General Medical Group Inc CurrentSince Aug 26, 2019 Accepting new patients
The Metrohealth System Current Accepting new patients
Southwest General Medical Group, Inc. Family Medicine CurrentSince Aug 26, 2019 Accepting new patients

Locations

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

7171 Royalton Rd
#201
North Royalton, OH 44133
Phone (440) 816-2878

10139 Royalton Rd
Ste H
North Royalton, OH 44133
Phone (440) 816-2878

7171 Royalton Rd
Ste 201
North Royalton, OH 44133
Phone (440) 816-5950

Interoperability endpoints

  • Direct secure messaging: gsong119496@direct.metrohealth.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 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1891870911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452638269",
            "telephone_number": "440-816-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 ROYALTON RD STE H",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334473",
            "telephone_number": "440-816-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35082229S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2425807",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gsong@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "10139 Royalton Rd Ste H",
            "city": "North Royalton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441334473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

Verify at the official NPI Registry.