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BORAM SONG
NPI 1063894475
Nurse Practitioner - Family in Englewood, NJ

Active since June 22, 2015PECOS Enrolled
200 GRAND AVE STE 201, ENGLEWOOD, NJ 07631(201) 944-3800(201) 944-3804 Get Directions Write a Review

NPPES record last updated: September 8, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 8, 2022, Aug 2, 2022 (2 updates tracked since 2022).

About Boram Song NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BORAM SONG (NPI 1063894475) is an individual family provider in Englewood, New Jersey, licensed in New Jersey (26NJ00890500) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Newark, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1063894475
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBORAM SONG
Location Address200 GRAND AVE STE 201Englewood, NJ 07631-4363
Mailing Address200 Grand Ave Ste 201Englewood, NJ 07631-4363 · (201) 944-3800 · Fax (201) 944-3804
Phone(201) 944-3800
Fax(201) 944-3804
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 22, 2015
Last NPPES UpdateSeptember 8, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2022
✔ NPI 1063894475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in NJ · 26NJ00890500✔ Licensed in NY · F339122
200 GRAND AVE STE 201, Englewood, NJ 07631
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Other Names 1

Other Name (5)Boram Song

Secondary Practice Location 1

Location 1243 Chestnut StNewark, NJ 07105-6501 · Phone (201) 944-3800 · Fax (201) 944-3804

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Boram Song is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880909548
PECOS Enrollment IDI20150811003915
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
88 services62 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
24 services22 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07631 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA ZAVALA NP
Nurse Practitioner (Family)
200 GRAND AVE STE 201
ENGLEWOOD, NJ 07631
Bergen County (201) 944-3800
INNA KIM NP
Nurse Practitioner (Family)
200 GRAND AVE STE 201
ENGLEWOOD, NJ 07631
Bergen County (201) 944-3800
SON DERMATOLOGY, PC
Dermatology
200 GRAND AVE STE 201
ENGLEWOOD, NJ 07631
Bergen County (201) 944-3800
SELIN PARK FNP
Nurse Practitioner
200 GRAND AVE STE 201
ENGLEWOOD, NJ 07631
Bergen County (201) 944-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boram Song's NPI number?

The NPI number for Boram Song is 1063894475. It was assigned to this individual provider in the NPPES registry on June 22, 2015.

Where is Boram Song located?

Boram Song practices at 200 Grand Ave Ste 201, Englewood, NJ 07631. The listed phone number is (201) 944-3800.

What is Boram Song's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Boram Song enrolled in Medicare?

Yes. Boram Song is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Boram Song was last updated on September 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.