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SONG HYON PAK M.D.
NPI 1962768333
Anesthesiology in Jacksonville, FL

Active since April 10, 2012PECOS Enrolled
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: October 23, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Song Hyon Pak M.d. NPPES

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

SONG HYON PAK M.D. (NPI 1962768333) is an individual anesthesiology provider in Jacksonville, Florida, licensed in Florida (ME127200) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962768333
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameSONG HYON PAKCredential: M.D.
Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865
Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000
Phone(904) 953-2000
Sole ProprietorNo
Enumeration DateApril 10, 2012
Last NPPES UpdateOctober 23, 2018
✔ NPI 1962768333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in FL · ME127200
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4500 SAN PABLO RD S, Jacksonville, FL 32224
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Song Hyon Pak M.d. 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Song Hyon Pak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northwood Anesthesia Associates LLC
153 mi
Anesthesiology
2407 CYPRESS RIDGE BLVD
Wesley Chapel, FL 33544
  • Reassigned Medicare billing, Florida enrollment
  • 176 clinicians in this Medicare group
NPI 1528630803 (954) 939-5000
North Pinellas Anesthesia Associates, PA
162 mi
Anesthesiology
14547 BRUCE B DOWNS BLVD
Tampa, FL 33613
  • Reassigned Medicare billing, Florida enrollment
  • 73 clinicians in this Medicare group
NPI 1104879816 (800) 437-2672

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

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.

KATHERINE L WALSH PA-C/MPH
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
DR. JAMI ANN ROTHE KINNUCAN M.D.
Internal Medicine (Gastroenterology)
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
GLENN SHI MD
Orthopaedic Surgery
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MICHELLE TULANG MD
Internal Medicine
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
RICARDO PAGAN MD
Hospitalist
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
CRYSTAL LYNN CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
LAUREN E FREED CRNA
Nurse Anesthetist, Certified Registered
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2000
MRS. MELINA VOLNER SOMMESE PA-C
Physician Assistant
4500 SAN PABLO RD S
JACKSONVILLE, FL 32224
Duval County (904) 953-2594

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 Hyon Pak's NPI number?

The NPI number for Song Hyon Pak is 1962768333. It was assigned to this individual provider in the NPPES registry on April 10, 2012.

Where is Song Hyon Pak located?

Song Hyon Pak practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.

What is Song Hyon Pak's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Song Hyon Pak enrolled in Medicare?

Yes. Song Hyon Pak is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Song Hyon Pak's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Song Hyon Pak reassigns Medicare benefits to 2 organizations: Northwood Anesthesia Associates LLC (Wesley Chapel, FL) and North Pinellas Anesthesia Associates, PA (Tampa, FL). Each 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 Song Hyon Pak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Song Hyon Pak was last updated on October 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.