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BRENTON JAY SEUNG HOON SONG DO
NPI 1184117004
Psychiatry & Neurology - Child & Adolescent Psychiatry in Erie, PA

Active since June 14, 2018PECOS EnrolledAccepts Medicare Assignment
4740 PEACH ST, ERIE, PA 16509(814) 454-3174(814) 616-8002 Get Directions Write a Review

NPPES record last updated: May 31, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 31, 2023, Jun 14, 2018 (2 updates tracked since 2018).

About Brenton Jay Seung Hoon Song Do NPPES

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

BRENTON JAY SEUNG HOON SONG DO (NPI 1184117004) is an individual child & adolescent psychiatry provider in Erie, Pennsylvania, licensed in Pennsylvania (OS021405) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Millcreek Community Hospital, and maintains a secondary practice location in Erie.

NPPES Registry Identity

NPI1184117004
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameBRENTON JAY SEUNG HOON SONGCredential: DO
Location Address4740 PEACH STErie, PA 16509-2008
Mailing Address1 Lecom PlErie, PA 16505-2571 · (814) 868-2529 · Fax (814) 868-2522
Phone(814) 454-3174
Fax(814) 616-8002
Sole ProprietorNo
Medical School CMSLake Erie Col Of Osteo Med At Seton Hill UnivGraduated 2018
Enumeration DateJune 14, 2018
Last NPPES UpdateMay 31, 20232 updates tracked since enumeration
NPPES CertifiedMay 31, 2023
✔ NPI 1184117004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in PA · OS021405
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
4740 PEACH ST, Erie, PA 16509
Open in Google Maps ↗

Secondary Practice Location 1

Location 1537 W 18th StErie, PA 16502-1722 · Phone (814) 454-3174 · Fax (814) 616-8002

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brenton Jay Seung Hoon Song Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012374630
PECOS Enrollment IDI20230613000740
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 Reassignments

3

Medicare enrollment records show Brenton Song reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Millcreek Community Hospital
Same address
Psychiatry
4740 PEACH ST
Erie, PA 16509
NPI 1245865815 (814) 454-3174
Medical Associates Of Erie
0.6 mi
Family Medicine
1589 W 54TH ST
Erie, PA 16509
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 69 clinicians in this Medicare group
NPI 1568580629 (814) 864-0690
Counselling Services Center Of Southeastern Erie County, Inc.
26 mi
Community/Behavioral Health
45 E WASHINGTON ST
Corry, PA 16407
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 7 clinicians in this Medicare group
NPI 1417968439 (814) 664-7761

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

Areas of Expertise CMS Part B claims

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.
121 services40 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Millcreek Community Hospital

Acute Care Hospitals · Erie, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390198
Location5515 Peach StreetErie, PA 16509 · Erie County
Emergency services

Lecom Health Corry Memorial Hospital

Critical Access Hospitals · Corry, PA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number391308
Location965 Shamrock LaneCorry, PA 16407 · Erie County
Emergency services

Other Providers at the Same Location NPPES 12

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

G RENEE THOMAS-CLARK DO
Psychiatry & Neurology (Child & Adolescent Psychiatry)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
MATTHEW L BEHAN
Psychiatry & Neurology (Psychiatry)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
MILLCREEK COMMUNITY HOSPITAL
Psychiatry & Neurology (Psychiatry)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
HOPE BLACKFORD
Social Worker
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
IVY ELIZABETH DEEGAN CRNP
Nurse Practitioner (Psychiatric/Mental Health)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
ROBERT J BEARFIELD
Counselor (Mental Health)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
DAVID E FIGUEROA DO
Psychiatry & Neurology (Child & Adolescent Psychiatry)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174
BELINDA ANN STILLMAN DO
Psychiatry & Neurology (Psychiatry)
4740 PEACH ST
ERIE, PA 16509
Erie County (814) 454-3174

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 Brenton Song's NPI number?

The NPI number for Brenton Song is 1184117004. It was assigned to this individual provider in the NPPES registry on June 14, 2018.

Where is Brenton Song located?

Brenton Song practices at 4740 Peach St, Erie, PA 16509. The listed phone number is (814) 454-3174.

What is Brenton Song's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Brenton Song enrolled in Medicare?

Yes. Brenton Song is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Brenton Song's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brenton Song reassigns Medicare benefits to 3 organizations: Millcreek Community Hospital (Erie, PA), Medical Associates Of Erie (Erie, PA) and Counselling Services Center Of Southeastern Erie County, Inc. (Corry, PA). Each 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 Brenton Song's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brenton Song accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Brenton 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.

Is Brenton Song affiliated with any hospitals?

According to CMS data, Brenton Song is affiliated with Millcreek Community Hospital and Lecom Health Corry Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Brenton Song was last updated on May 31, 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.