MICHAEL SONG (MD) – Anesthesiology Physician, NPI 1104925080

MICHAEL SONG (MD) is a healthcare provider. based in Jackson, Michigan. specializing in ANESTHESIOLOGY. They hold the professional credentials MD. They hold a License No. 25MA06850400 (NJ). The NPI Number for MICHAEL SONG (MD) is 1104925080

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL SONG (MD)
NPI
1104925080
Phone
(517) 787-6440
Address
255 W MICHIGAN AVE
Enumeration Date
21 September 2006
Last Update Date
29 June 2012

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
4075471654
Graduation Year
1991 (35 years ago)
PAC ID
6901898337
Group Practice PAC ID
0749598001
Professional Enrollment ID
I20210908001439
Address ID
FL347879556WI15548DRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,667 ANESTHESIOLOGY in NJ

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Provider Addresses for MICHAEL SONG (MD)

  • 255, West Michigan Avenue, Jackson, Jackson County, Michigan, 49201, United States

    P. O. BOX 1123

    JACKSON, MI 492012218

    Phone: (517) 787-6440

    Type: Mailing

  • Franklin Turnpike, Indian Ridge, Cragmere, Mahwah, Bergen County, New Jersey, 07430, United States

    SUITE 206

    RAMSEY, NJ 074461177

    Phone: (201) 962-7282

    Fax: (201) 962-7283

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $103.

Total Amount is formed as General ($103) + Research ($0) + Ownership ($0) = $103.

Last reported payment date: 2024-12-27 • Largest payer in this snapshot: Stryker Corporation ($85).

Total Amount

$103

General + Research + Ownership

Payments

3

Total payment records

General Amount

$103

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2021-09-08

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
I20210908001439IAnesthesiologyFLTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49201)

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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: 0749598001View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)NC
Certified Registered Nurse Anesthetist (Crna)CA
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)IN

Reviews

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Frequently asked questions

Can I cross-check MICHAEL SONG (MD) using NPI 1104925080?
NPI 1104925080 belongs to MICHAEL SONG (MD); compare other details if you need extra assurance.
Active or inactive — what applies to MICHAEL SONG (MD)?
You should see MICHAEL SONG (MD) as active in CMS-hosted NPPES data.
What expertise is attributed to MICHAEL SONG (MD)?
MICHAEL SONG (MD)'s specialty line reads Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with MICHAEL SONG (MD)?
Directory geography for MICHAEL SONG (MD) centers on Jackson, Michigan.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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