TAE KYUNG SONG (M.D.) – Vascular Surgery Physician, NPI 1043407430
Vascular Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
677 VASCULAR SURGERY in CA
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Provider Addresses for TAE KYUNG SONG (M.D.)
Stanford Hospital, 300, Pasteur Drive, Stanford, Palo Alto, Santa Clara County, California, 94305, United States
ROOM H3600
STANFORD, CA 943052200
Phone: (650) 723-3639
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $582.
Total Amount is formed as General ($582) + Research ($0) + Ownership ($0) = $582.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($274).
Total Amount
$582
General + Research + Ownership
Payments
30
Total payment records
General Amount
$582
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| W. L. Gore & Associates, Inc. | $274 |
| Bolton Medical Inc | $116 |
| LeMaitre Vascular, Inc. | $52 |
| Cook Medical LLC | $31 |
| Silk Road Medical, Inc. | $30 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-04-21
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050421000698 | I | Vascular Surgery | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15 | 12 | $0 |
Insurance plans in this area (ZIP 94305)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | OH | |
| Nurse Practitioner | CA | |
| Internal Medicine | CA | |
| Internal Medicine | CA | |
| Physician Assistant | CA | |
| N E U R O L O G Y | CA | |
| Internal Medicine | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Family Practice, Sports Medicine | CA | |
| Internal Medicine | NY |
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