PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC
NPI 1336682764
Physical Medicine & Rehabilitation - Pain Medicine in Saint Cloud, FL

NPI Status: Active since December 03, 2016

Contact Information

2801 17TH ST UNIT 202
SAINT CLOUD, FL
ZIP 34769
Phone: (407) 906-1328
Fax: (866) 425-8143

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  • Organization
  • Physical Medicine & Rehabilitation
  • Pain Medicine
  • Accepts Insurance

About PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC

This page provides the complete NPI Profile along with additional information for Palm Tree Interventional Pain Management, Pllc, a provider established in Saint Cloud, Florida operating as a Physical Medicine & Rehabilitation, focusing in pain medicine . The healthcare provider is registered in the NPI registry with number 1336682764 assigned on December 2016. The practitioner's primary taxonomy code is 2081P2900X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Palm Tree Interventional Pain Management, Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jason Jeong Hwan Song Md (Medical Director)

NPI
1336682764
Provider Name
PALM TREE INTERVENTIONAL PAIN MANAGEMENT, PLLC
Entity Type
Organization
Location Address
2801 17TH ST UNIT 202 SAINT CLOUD, FL 34769
Location Phone
(407) 906-1328
Location Fax
(866) 425-8143
Mailing Address
2801 17TH ST UNIT 202 SAINT CLOUD, FL 34769
Mailing Phone
(407) 906-1328
Mailing Fax
(866) 425-8143
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-03-2016
Last Update Date
10-01-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation Pain Medicine

Taxonomy Code
2081P2900X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208100000XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation

(FL)
2208VP0014XAllopathic & Osteopathic Physicians

Pain Medicine
Interventional Pain Medicine

(FL)

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Clarity VALUE Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite VALUE Bronze - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
  • Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JASON JEONG HWAN SONG MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(267) 312-9857

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
020119900MEDICAID (05)FL 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1336682764, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
3
Doubled → 6
Pos 4
6
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
8
Unchanged
Pos 7
2
Doubled → 4
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 6 → 12 → 3 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 6 + 6 + 1 + 2 + 8 + 4 + 7 + 1 + 2 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1336682764.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Physical Therapist
2801 17TH ST UNIT 202
SAINT CLOUD, FL 34769
Pain Medicine (Pain Medicine)
2801 17TH ST UNIT 202
SAINT CLOUD, FL 34769
Anesthesiology (Pain Medicine)
2801 17TH ST UNIT 202
SAINT CLOUD, FL 34769

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336682764, enumerated as an "organization" on December 03, 2016.

The provider is located at 2801 17TH ST UNIT 202 SAINT CLOUD, FL 34769 and the phone number is (407) 906-1328.

Physical Medicine & Rehabilitation with taxonomy code 2081P2900X and a focus in Pain Medicine.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.