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

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: October 18, 2026.

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

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 Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Myoungsu Song reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Promise Healthcare Nfp
Same address
Federally Qualified Health Center (FQHC)
819 BLOOMINGTON RD
Champaign, IL 61820
  • Reassigned Medicare billing, Illinois enrollment
  • 48 clinicians in this Medicare group
NPI 1578821005 (217) 356-1558

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
DR. CORINNE E KOHLER MD
Family Medicine
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
RIVER ANDRES PA
Physician Assistant
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
PROMISE HEALTHCARE
Counselor (Mental Health)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
VALERIE CINTRON
Social Worker (Clinical)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
JENNY M. DAAB PNP
Nurse Practitioner (Pediatrics)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
ABDELKRIM HADJ SAID PH. D.
Counselor (Professional)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 356-1558
JOHN S ANDERSON
Dentist (General Practice)
819 BLOOMINGTON RD
CHAMPAIGN, IL 61820
Champaign County (217) 403-5477

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 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.

Where is Myoungsu Song located?

Myoungsu Song practices at 819 Bloomington Rd, Champaign, IL 61820. The listed phone number is (217) 356-1558.

What is Myoungsu Song's specialty?

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

Is Myoungsu Song enrolled in Medicare?

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

Which organization bills Medicare for Myoungsu Song's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Myoungsu Song reassigns Medicare benefits to Promise Healthcare Nfp (Champaign, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Myoungsu Song's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Myoungsu Song accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Myoungsu Song as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Myoungsu Song was last updated on January 24, 2023. 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.