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YONG SOO SO, M.D., P.C.
NPI 1356405294
General Practice in Eastpointe, MI

Active since December 21, 2006
22001 KELLY RD, EASTPOINTE, MI 48021(586) 778-0209(586) 778-0202 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Yong Soo So, M.d., P.c. NPPES

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

YONG SOO SO, M.D., P.C. (NPI 1356405294) is a healthcare organization registered as a general practice in Eastpointe, Michigan and active in the NPI registry since December 2006. The organization lists Yong Soo So, President, as its authorized official.

NPPES Registry Identity

NPI1356405294
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameYONG SOO SO, M.D., P.C.
Location Address22001 KELLY RDEastpointe, MI 48021-2708
Mailing Address22001 Kelly RdEastpointe, MI 48021-2708 · (586) 778-0209 · Fax (586) 778-0202
Phone(586) 778-0209
Fax(586) 778-0202
Organization SubpartNo
Authorized OfficialYong Soo SoPresident · (586) 778-0209
Enumeration DateDecember 21, 2006
Last NPPES UpdateApril 20, 2008
✔ NPI 1356405294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MI · YS037124
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
22001 KELLY RD, Eastpointe, MI 48021
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Other Identifiers 3

Medicaid4641238MI
Medicare UPINB46014MI
Medicare PIN0N89590MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yong Soo So, M.d., P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20040608001028Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Yong Soo So, M.D., P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Yong So, M.D.
General Practice
NPI 1073708046
22001 KELLY RD
Eastpointe, MI 48021
(586) 778-0209
✔ PECOS✔ Accepts MedicareSame address

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

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 Yong Soo So, M.D., P.C.'s NPI number?

The NPI number for Yong Soo So, M.D., P.C. is 1356405294. It was assigned to this organization in the NPPES registry on December 21, 2006.

Where is Yong Soo So, M.D., P.C. located?

Yong Soo So, M.D., P.C. is located at 22001 Kelly Rd, Eastpointe, MI 48021. The listed phone number is (586) 778-0209.

What is Yong Soo So, M.D., P.C.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Yong Soo So, M.D., P.C. enrolled in Medicare?

Yes. Yong Soo So, M.D., P.C. is registered in the Medicare PECOS enrollment system.

When is Yong Soo So, M.D., P.C.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Yong Soo So, M.D., P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Yong Soo So, M.D., P.C.. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Yong Soo So, M.D., P.C. was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.