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MR. SONG JUN MOON PA-C
NPI 1780019539
Physician Assistant in Lackland Afb, TX

Active since September 12, 2013PECOS EnrolledAccepts Medicare Assignment
1100 WILFORD HALL LOOP BLDG 4554, LACKLAND AFB, TX 78236(210) 292-1455 Get Directions Write a Review

NPPES record last updated: December 17, 2024. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Dec 17, 2024, Nov 6, 2020, May 23, 2018 (3 updates tracked since 2018).

About Mr. Song Jun Moon Pa-c NPPES

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

MR. SONG JUN MOON PA-C (NPI 1780019539) is an individual physician assistant in Lackland Afb, Texas, licensed in Texas (PA18550) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1780019539
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. SONG JUN MOONCredential: PA-C
Location Address1100 WILFORD HALL LOOP BLDG 4554Lackland Afb, TX 78236-5638
Mailing Address1100 Wilford Hall LoopLackland Afb, TX 78236-5638 · (210) 292-1455
Phone(210) 292-1455
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 12, 2013
Last NPPES UpdateDecember 17, 20243 updates tracked since enumeration
NPPES CertifiedDecember 17, 2024
✔ NPI 1780019539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA18550
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.
Also ListedMilitary Health Care ProviderTaxonomy 171000000X
1100 WILFORD HALL LOOP BLDG 4554, Lackland Afb, TX 78236
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, UnitedHealthcare.Insurance ›

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

Mr. Song Jun Moon Pa-c 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 ID9436661485
PECOS Enrollment IDI20250625000934
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 78236 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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 20

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

DR. REGINA MARIA REINSVOLD M.D.
Anesthesiology
1100 WILFORD HALL LOOP BLDG 4554
LACKLAND AFB, TX 78236
Bexar County (210) 292-6255
ROBERT LEE LMFT
Marriage & Family Therapist
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-6255
DR. FINIANNE JIMENEZ UMALI-CORRY DO, MPH
Internal Medicine
1100 WILFORD HALL LOOP BLDG 4554
LACKLAND AFB, TX 78236
Bexar County (210) 292-4277
DAVID CHRISTOPHER MARI D.O.
Allergy & Immunology
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-6255
DR. HANNAH GHONG-JU AHN MD
Radiology (Diagnostic Radiology)
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-4482
MRS. CASSANDRA LANETTE DOUGLAS PHARMACIST
Pharmacist
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (102) 292-1144
DR. CHARLES RICHARD ELCHERT JR. D.C.
Chiropractor
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-3587
DR. LISA LEADER KOHLER OD
Optometrist
1100 WILFORD HALL LOOP BLDG 4554
JBSA LACKLAND, TX 78236
Bexar County (210) 292-6255

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 Song Moon's NPI number?

The NPI number for Song Moon is 1780019539. It was assigned to this individual provider in the NPPES registry on September 12, 2013.

Where is Song Moon located?

Song Moon practices at 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236. The listed phone number is (210) 292-1455.

What is Song Moon's specialty?

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

Is Song Moon enrolled in Medicare?

Yes. Song Moon 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.

What insurance does Song Moon accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and UnitedHealthcare list Song Moon 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.

When was this NPI record last updated?

The NPPES record for Song Moon was last updated on December 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.