JESSICA SONG
NPI 1669245247
Nurse Practitioner - Family in Los Angeles, CA

Q: What is Jessica Song's NPI number?

The NPI number for Jessica Song is 1669245247. It was assigned to this individual provider in the NPPES registry on November 6, 2023.

Q: What is Jessica Song's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Song was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since November 06, 2023PECOS Enrolled

3727 W 6TH ST STE 200, LOS ANGELES, CA 90020(213) 235-2500 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jessica Song NPPES

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

JESSICA SONG (NPI 1669245247) is an individual family provider in Los Angeles, California, licensed in California (95024014) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669245247

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJESSICA SONG

Location Address3727 W 6TH ST STE 200Los Angeles, CA 90020-5108

Mailing Address1745 Holly Dr Apt 106Glendale, CA 91206-4142

Phone(213) 235-2500

Sole ProprietorYes

Enumeration DateNovember 6, 2023

NPPES CertifiedNovember 4, 2023

✔ NPI 1669245247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95024014

3727 W 6TH ST STE 200, Los Angeles, CA 90020

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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 (PECOS)

Jessica 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90020 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

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

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 9

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

DR. IDA TUWATANANURAK D.O.

Family Medicine