Individual provider Active NPI

Young Min Song, M.D.

  • Neurology Physician
  • Tucson, AZ
National Provider Identifier
1932394061
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
43281 Issued in AZ
Practice address
2450 E River Rd
Tucson, AZ 85718-6522
Phone
(520) 795-7750
Fax
(520) 320-2155
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 43281 AZ Primary
Clinical Neurophysiology Physician 2084N0600X 43281 AZ

Addresses

Primary practice location

2450 E River Rd
Tucson, AZ 85718-6522

Mailing address

2450 E River Rd
Tucson, AZ 85718-6522
Phone (520) 795-7750

Other identifiers 3

IdentifierTypeStateIssuer
A105993OtherCAMEDICAL BOARD
523941MedicaidAZ
43281OtherAZAZ MEDICAL BOARD

Other names 1

  • Mindy Song Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100721000263 AZ Practitioner - Neurology 5092847491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurological Associates of TucsonGroup PAC ID 5092709527, 60 clinicians

Practice addresses (Care Compare)

2450 E River Rd
Tucson, AZ 85718-6526
Phone (520) 795-7750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43281AZMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurological Associates of Tucson Neurology CurrentSince Jul 1, 2010 Accepting new patients
Carondelet Specialist Group, Inc Past Accepting new patients

Locations

1601 W Saint Marys Rd
Ste 100
Tucson, AZ 85745
Phone (520) 872-3000

2450 E River Rd
Tucson, AZ 85718
Phone (520) 795-7750

Interoperability endpoints

  • Direct secure messaging: young.song@cfn.eclinicaldirectplus.com

Organizations & group practices 2

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 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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302825600000",
    "number": "1932394061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186522",
            "telephone_number": "520-795-7750",
            "fax_number": "529-320-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186522",
            "telephone_number": "520-795-7750",
            "fax_number": "520-320-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "YOUNG",
        "middle_name": "MIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2011-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "43281",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "AZ",
            "license": "43281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "A105993",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523941",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ MEDICAL BOARD",
            "identifier": "43281",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "SONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.