Boram Song, in Englewood, NJ - Medicare Nurse Practitioner

Boram Song, is a medicare enrolled "Nurse Practitioner - Family" in Englewood, New Jersey. Her current practice location is 200 Grand Ave Ste 201, Englewood, New Jersey. You can reach out to her office (for appointments etc.) via phone at (201) 944-3800.

Boram Song is licensed to practice in New Jersey (license number 26NJ00890500) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063894475.

Contact Information

	Boram Song,
	200 Grand Ave Ste 201, Englewood, NJ 07631-4363
	(201) 944-3800
	(201) 944-3804

Map and Direction

Provider's Profile

Full Name	Boram Song
Gender	Female
Speciality	Nurse Practitioner - Family
Location	200 Grand Ave Ste 201, Englewood, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063894475
Provider Enumeration Date: 06/22/2015
Last Update Date: 09/08/2022

Medicare PECOS Information:

PECOS PAC ID: 4880909548
Enrollment ID: I20150811003915

Medical Identifiers

Medical identifiers for Boram Song such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063894475	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	F339122 (New York)	Secondary
363LF0000X	Nurse Practitioner - Family	26NJ00890500 (New Jersey)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Boram Song allows following entities to bill medicare on her behalf.

Entity Name	Bronx Medical Practice Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356726087 PECOS PAC ID: 9739496100 Enrollment ID: O20150917000004

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Boram Song is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Boram Song, 200 Grand Ave Ste 201, Englewood, NJ 07631-4363 Ph: (201) 944-3800	Boram Song, 200 Grand Ave Ste 201, Englewood, NJ 07631-4363 Ph: (201) 944-3800

Reviews and Comments

Nurse Practitioner Nurses in Englewood, NJ

Michelle May Roe, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 21 Oakland St, Englewood, NJ 07631 Phone: 917-753-8013
Min Hwang, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Grand Ave Ste 203, Englewood, NJ 07631 Phone: 201-944-3115 Fax: 866-278-0484
Dr. Jaime Luis Betancourt, DNP, MPH, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 Engle St Bldg 5th, Englewood, NJ 07631 Phone: 201-568-5250 Fax: 201-568-5358
Miss Eun Mi Joo, RN,FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3408 Windsor Park Ct, Englewood, NJ 07631 Phone: 201-212-3559
Caitlin Colleen Flynn, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 350 Engle St Fl 4, Englewood, NJ 07631 Phone: 201-568-5250
Debra Tawil, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 350 Engle St, Englewood, NJ 07631 Phone: 201-894-3202

Boram Song, - Medicare Nurse Practitioner in Englewood, NJ