NPIMap

Individual provider Active NPI

Min Song, MD

  • Internal Medicine Physician
  • Milton, MA
National Provider Identifier
1982715256
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233356 Issued in MA
Practice address
199 Reedsdale Rd
Milton, MA 02186
Phone
(617) 696-7600
Fax
(617) 696-7604
NPI assigned
Aug 31, 2006
Last updated
Aug 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233356 MA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 233356 MA

Addresses

Primary practice location

199 Reedsdale Rd
Milton, MA 02186

Mailing address

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 696-7600

Other names 1

  • Min Keun Song Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080411000058 MA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 3173600384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

100 Highland St
Milton, MA 02186-3881
Phone (617) 696-5030

100 Highland St
Milton, MA 02186-3884

100 Highland St
Suite 105
Milton, MA 02186-3874
Phone (617) 696-7600

109 Andrew Ave
Wayland, MA 01778-3156
Phone (781) 453-8450

200 Boylston St
Chestnut Hill, MA 02467-2012
Phone (617) 278-8640

93 Pond St
Sharon, MA 02067-2015
Phone (781) 784-9212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233356MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation Internal Medicine CurrentSince Dec 1, 2007 Accepting new patients
The Bostonian SNF LLC Past Accepting new patients
Metro Health Foundation of Massachusetts, Inc. Past Accepting new patients
49 Thomas Patten Drive Operating Company, LLC Past Accepting new patients
Ellis Nursing Home, Inc. Past Accepting new patients

Locations

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: msong253993@direct.bilh.masshiway.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascend HospiceWorcester, MA, CCN 221566 Hospice Contracted Managing Employee (100%)
Corporate Director (100%)		 Jan 1, 2009
Jan 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1982715256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 REEDSDALE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "02186",
            "telephone_number": "617-696-7600",
            "fax_number": "617-696-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 REEDSDALE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "02186",
            "telephone_number": "617-696-7600",
            "fax_number": "617-696-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "MIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "233356",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "233356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIN KEUN",
            "last_name": "SONG",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milton, MA

Sources for this page

Verify at the official NPI Registry.