MYOUNGSU SONG
NPI 1154932218
Dentist - General Practice in Champaign, IL

Q: What is Myoungsu Song's NPI number?

The NPI number for Myoungsu Song is 1154932218. It was assigned to this individual provider in the NPPES registry on August 12, 2020.

Q: What is Myoungsu Song's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Myoungsu Song was last updated on January 24, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 12, 2020PECOS Enrolled

819 BLOOMINGTON RD, CHAMPAIGN, IL 61820(217) 356-1558 Get Directions Write a Review

NPPES record last updated: January 24, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 24, 2023, Aug 12, 2020 (2 updates tracked since 2020).

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About Myoungsu Song NPPES

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

MYOUNGSU SONG (NPI 1154932218) is an individual general practice provider in Champaign, Illinois, licensed in Illinois (019032794) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154932218

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameMYOUNGSU SONG

Location Address819 BLOOMINGTON RDChampaign, IL 61820-2101

Mailing Address2050 E Algonquin Rd Ste 610Schaumburg, IL 60173-4166 · (888) 988-4066

Phone(217) 356-1558

Sole ProprietorYes

Enumeration DateAugust 12, 2020

Last NPPES UpdateJanuary 24, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 24, 2023

✔ NPI 1154932218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in IL · 019032794

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

819 BLOOMINGTON RD, Champaign, IL 61820

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61820 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

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

JESSICA LYNN MANDRELL

Nurse Practitioner (Psychiatric/Mental Health)