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JI SOO SONG
NPI 1619792900
Physician Assistant in Santa Ana, CA

Active since November 20, 2024PECOS EnrolledAccepts Medicare Assignment
1211 N BROADWAY, SANTA ANA, CA 92701(888) 367-1850 Get Directions Write a Review

NPPES record last updated: November 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ji Soo Song NPPES

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

JI SOO SONG (NPI 1619792900) is an individual physician assistant in Santa Ana, California and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1619792900
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJI SOO SONG
Location Address1211 N BROADWAYSanta Ana, CA 92701-3411
Mailing Address1211 N BroadwaySanta Ana, CA 92701-3411
Phone(888) 367-1850
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateNovember 20, 2024
Last NPPES UpdateNovember 21, 2024
NPPES CertifiedNovember 21, 2024
✔ NPI 1619792900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1211 N BROADWAY, Santa Ana, CA 92701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ji Soo Song 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 ID9537696455
PECOS Enrollment IDI20241217001136
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 92701 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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

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

CALIFORNIA DERMATOLOGY INSTITUTE PC
Non-Pharmacy Dispensing Site
1211 N BROADWAY
SANTA ANA, CA 92701
Orange County (888) 367-1850

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 Ji Soo Song's NPI number?

The NPI number for Ji Soo Song is 1619792900. It was assigned to this individual provider in the NPPES registry on November 20, 2024.

Where is Ji Soo Song located?

Ji Soo Song practices at 1211 N Broadway, Santa Ana, CA 92701. The listed phone number is (888) 367-1850.

What is Ji Soo Song's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ji Soo Song enrolled in Medicare?

Yes. Ji Soo 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.

When was this NPI record last updated?

The NPPES record for Ji Soo Song was last updated on November 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.