DR. JINSUP SONG (NPI# 1295721777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295721777 |
| Entity Type | Individual |
| Full Name | DR. JINSUP SONG |
| Credential | DPM PHD |
| Practice Address |
Temple University Foot and Ankle Institute 8th At Race Street Philadelphia PA 19107-2496 |
| Mailing Address |
Temple University Foot and Ankle Institute Po Box 827282 Philadelphia PA 19182-0001 |
| Practice Telephone | 2152386600 |
| Practice Fax Number | 2156294905 |
| Mailing Telephone | 2152386600 |
| Mailing Fax Number | 2156290716 |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2010-07-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | SC004393L | PA | Podiatric Medicine & Surgery Service Providers |
| N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
SC004393L | PA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | BLUE SHIELD OF PA | S0819326 | 01 |
| PA | 0018076090003 | 05 | |
| PA | KEYSTONE MERCY | 1125735 | 01 |
| PA | 1807609 | 05 | |
| PA | AETNA | 2353876 | 01 |
| PA | RAILROAD MEDICARE | 480030054 | 01 |
| PA | KEYSTONE HEALTH PLAN PPO | 893038 | 01 |
| PA | KEYSTONE HEALTH PLAN HMO | 0499950000 | 01 |
| PA | ELDER HEALTH / BRAVO | 9231 | 01 |
| PA | OXFORD | P2665731 | 01 |
| PA | UNITED HEALTH CARE | 231365971 | 01 |
| NJ | NJ MEDICAL ASSISTANCE | 8259607 | 01 |
| PA | HEALTH PARTNERS | 28824 | 01 |
| PA | HUMANA | 231365971 | 01 |
| PA | HEALTH NET | 3Y2326 | 01 |
| PA | HEALTH AMERICA HEALTH ASSURANCE | 435767 | 01 |
| PA | INTER-CITY | H19826 | 01 |
| PA | TRI-CARE | 231365971071 | 01 |
| Street Address |
TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE 8TH AT RACE STREET |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-2496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326033325 | Kieran Thomas Mahan | Podiatrist | Temple University Foot and Ankle Institute, 8th At Race Street, Philadelphia, PA 19117-2496 | 2005-09-15 |
| 1225023237 | Howard James Palamarchuk | Podiatrist | Temple University Foot and Ankle Institute, 8th At Race Street, Philadelphia, PA 19117-2496 | 2005-09-15 |
| 1467447466 | Ziad George Labbad | Podiatrist | Temple University Foot and Ankle Institute, 8th At Race Streets, Philadelphia, PA 19117-2496 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543109 | Kimberly Nguyen Dpm PC | Podiatrist | 1930 S Broad St Ste 19, Philadelphia, PA 19145-2328 | 2019-11-21 |
| 1811476658 | David Khakshoor | Podiatrist | 1703 Borbeck Ave Fl 1, Philadelphia, PA 19111-3514 | 2018-08-13 |
| 1851877179 | Andrew Mermelstein | Podiatrist | 5800 Roxborough Avenue, Philadelphia, PA 19128 | 2018-07-19 |
| 1053835264 | Marvin Marcelin | Podiatrist | 5735 Ridge Ave Ste 208, Philadelphia, PA 19128-1747 | 2017-07-29 |
| 1598287054 | Taylor Wasserleben | Podiatrist | 235 N Broad St Ste 300, Philadelphia, PA 19107-1511 | 2017-07-16 |
| 1952718975 | Travon Owens | Podiatrist | 4522 Westminster Ave, Philadelphia, PA 19131-5213 | 2014-07-22 |
| 1558675801 | Duane Romana | Podiatrist | 1865 Welsh Rd, Apt J-9, Philadelphia, PA 19115-4764 | 2010-07-28 |
| 1144532748 | Kimberly Hoang Nguyen | Podiatrist | 1311 South St, Philadelphia, PA 19147-1867 | 2010-07-12 |
| 1396973152 | Kwasi Y Kwaadu | Podiatrist | 148 N 8th Street, Philadelphia, PA 19107-2496 | 2009-06-30 |
| 1043453996 | Foot Health Centers, Pa | Podiatrist | 6911 Castor Ave, Philadelphia, PA 19149-1702 | 2009-04-08 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.