Angie U. Song, M.D.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

G84700 Issued in CA

Practice address

1225 N H St
Lompoc, CA 93436-3301

Phone

(805) 737-8700

Fax

(805) 737-8649

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Otolaryngology

Education

George Washington University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lompoc Valley Medical CenterGroup PAC ID 9739275595, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lompoc Valley Medical Center Hospital, Lompoc, CA, CCN 050110

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: angie.song@lvmc.eclinicaldirectplus.com

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.

• Lompoc Valley Medical Center

  • General Practice Physician
  • Lompoc, CA
  • NPI 1649282856
  Medicare reassignment Care Compare group NPD
• HCA Healthone LLC

  • General Acute Care Hospital
  • Englewood, CO
  • NPI 1396790200
  NPD (past)
• Southwest Ear Nose & Throat Consultants PA

  • Otolaryngology Physician
  • El Paso, TX
  • NPI 1932240629
  NPD (past)
• Tenet Hospitals Limited

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1215969787
  NPD (past)
• Tenet Hospitals Limited

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1700801909
  NPD (past)

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

• Lompoc Valley Medical Center

  • General Acute Care Hospital
  • Lompoc, CA
  • NPI 1194711952
  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1982605259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 EVERGREEN PT RD",
            "city": "MEDINA",
            "state": "WA",
            "postal_code": "98039",
            "telephone_number": "425-324-6144",
            "fax_number": "425-455-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N H ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934363301",
            "telephone_number": "805-737-8700",
            "fax_number": "805-737-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 116th Ave NE",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043800",
            "country_code": "US",
            "telephone_number": "425-324-6144",
            "fax_number": "425-455-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "ANGIE",
        "middle_name": "U.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "WA",
            "license": "60136134",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "G84700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174028401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S2230",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Slagle, PPS
• Jeanie Marie Sleigh, LMHP, CADCII
• Kevin Scott Smith, REGISTERED CERTIFICA
• Autumn J Soltero, P.T.
• Ashley Somics
• Ji Eun Song
• Pinhkeo Southaphanh, O.D.
• Maysee Ann Spain
• Alina Staniger, ADDICTIONS STUDIES
• Anthony Joseph Starinieri, DDS

• Otolaryngology/Facial Plastic Surgery Physician in Lompoc, CA
• Providers in Lompoc, CA by specialty
• Otolaryngology/Facial Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.