NPIMap

Individual provider Active NPI

Kimberly Song, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Brooklyn, NY
National Provider Identifier
1962720425
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
295045-1 Issued in NY
Practice address
8318 4TH Ave
Brooklyn, NY 11209-4413
Phone
(718) 748-0500
NPI assigned
May 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 295045-1 NY
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 295045-1 NY Primary

Addresses

Primary practice location

8318 4TH Ave
Brooklyn, NY 11209-4413

Mailing address

408 E 92ND St Apt 23a
New York, NY 10128-6838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190920000980 NY Practitioner - General SurgeryPractitioner - Thoracic Surgery 7810281102 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Thoracic Surgery
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronxcare Health SystemGroup PAC ID 3870404429, 335 clinicians

Practice addresses (Care Compare)

1190 5TH Ave
GP2W
New York, NY 10029-6503
Phone (212) 241-5646

1650 Grand Concourse
FL 3
Bronx, NY 10457-7606
Phone (718) 518-5131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295045-1NYMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jan 1, 2023 Accepting new patients
Bronxcare Health System CurrentSince Sep 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Sep 1, 2019 Accepting new patients
Bronxcare Health System CurrentSince Sep 1, 2019 Accepting new patients
Bronxcare Health System Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1650 Grand Concourse
Fl 3
Bronx, NY 10457
Phone (718) 518-5046

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

14004 58th Rd
Flushing, NY 11355
Phone (718) 463-4155

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1190 5th Ave
#2W
New York, NY 10029
Phone (212) 241-5646

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: ksong1040290@nychhc.direct-ci.com
  • Direct secure messaging: kimberlysong@mai.allscriptsdirect.net

Organizations & group practices 11

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 11

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": "1273276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1962720425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E 92ND ST APT 23A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8318 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094413",
            "telephone_number": "718-748-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-08",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "295045-1",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "295045-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.