KHIM LEANG LY SONG (NP) – Family Nurse Practitioner, NPI 1417636689

KHIM LEANG LY SONG (NP) is a healthcare provider. based in Alhambra, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 95021730 (CA). The NPI Number for KHIM LEANG LY SONG (NP) is 1417636689

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KHIM LEANG LY SONG (NP)
NPI
1417636689
Phone
(833) 476-7377
Address
328 S 1ST ST STE D
Enumeration Date
14 July 2023
Last Update Date
14 July 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5629972172
Graduation Year
2021 (5 years ago)
PAC ID
0446613012
Group Practice PAC ID
7012230212
Professional Enrollment ID
I20230830000083
Address ID
CA917803682TE5101XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for KHIM LEANG LY SONG (NP)

  • 328 S 1ST ST STE D

    ALHAMBRA, CA 918013790

    Phone: (833) 476-7377

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-08-30

PECOS data refreshed: 2026-05-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230830000083INurse PractitionerCATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes2,044214$0
99305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes218177$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes12453$0
View full utilization report →

Insurance plans in this area (ZIP 91801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012230212View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerIL
Pain ManagementCA
Pain ManagementCA
-NY
Physical Medicine And RehabilitationCA
Nurse PractitionerCA
-MD
Physical Medicine And RehabilitationCA
Physical Medicine And RehabilitationCA

Reviews

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Frequently asked questions

How do payers reference KHIM LEANG LY SONG (NP)?
For KHIM LEANG LY SONG (NP), use NPI 1417636689 as the unique 10-digit identifier.
Would KHIM LEANG LY SONG (NP) appear as active to a payer?
You can treat KHIM LEANG LY SONG (NP) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to KHIM LEANG LY SONG (NP)?
KHIM LEANG LY SONG (NP)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in California is KHIM LEANG LY SONG (NP) registered?
Use Alhambra, California as the headline location for KHIM LEANG LY SONG (NP) here.
Can I trust this NPI listing for KHIM LEANG LY SONG (NP)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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