JIE SONG (M.D.) – Anatomic Pathology & Clinical Pathology Physician, NPI 1114223351
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
311 PATHOLOGY in IN
Provider Addresses for JIE SONG (M.D.)
2434 INTERSTATE PLAZA DR
HAMMOND, IN 463242671
Phone: (219) 845-4043
Type: Location
28100 N ASHLEY CIR STE 106
LIBERTYVILLE, IL 600489478
Phone: (847) 996-1030
Fax: (847) 996-0791
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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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: 2023-04-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20110701000134 | I | Pathology | IN | TBD |
| I20230421000922 | I | Pathology | IL | 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 |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,152 | 817 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 219 | 95 | $0 |
| 84165 | Protein measurement, serum | 200 | 181 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 172 | 150 | $0 |
| 86334 | Immunologic analysis technique on serum (immunofixation) | 97 | 88 | $0 |
Insurance plans in this area (ZIP 46324)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | IN | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 65 | 57 |
| PATHOLOGY | IN | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 17 | 16 |
| PATHOLOGY | IN | 88342 | Tissue or cell analysis by immunologic technique | 47 | 42 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IL | |
| P A T H O L O G Y | IL | |
| D E R M A T O L O G Y | IL | |
| Physician Assistant | IL | |
| P A T H O L O G Y | IL | |
| Nurse Practitioner | IL | |
| D E R M A T O L O G Y | IL | |
| P A T H O L O G Y | IL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | IL |
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