Ji Yeong Gendron Song, - Medicare Nurse Practitioner in Walnut Creek, CA

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Ji Yeong Gendron Song, is a medicare enrolled "Nurse Practitioner - Family" in Walnut Creek, California. She graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Minuteclinic Diagnostic Medical Group Of California Inc and her current practice location is 738 Bancroft Road, Walnut Creek, California. You can reach out to her office (for appointments etc.) via phone at (925) 938-8525.

Ji Yeong Gendron Song is licensed to practice in California (license number 95017511) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1033788898.

Contact Information

Ji Yeong Gendron Song,
738 Bancroft Road,
Walnut Creek, CA 94598-1250
(925) 938-8525
Not Available

Map and Direction




Provider's Profile

Full NameJi Yeong Gendron Song
GenderFemale
SpecialityNurse Practitioner
Experience3 Years
Location738 Bancroft Road, Walnut Creek, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ji Yeong Gendron Song graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1033788898
  • Provider Enumeration Date: 06/24/2021
  • Last Update Date: 06/26/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5890197511
  • Enrollment ID: I20210716001481

Medical Identifiers

Medical identifiers for Ji Yeong Gendron Song such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033788898NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family NP95017511 (California)Secondary
363LF0000XNurse Practitioner - Family 95017511 (California)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Minuteclinic Diagnostic Medical Group Of California Inc822419137484

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ji Yeong Gendron Song allows following entities to bill medicare on her behalf.
Entity NameMinuteclinic Diagnostic Medical Group Of California Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033309372
PECOS PAC ID: 8224191374
Enrollment ID: O20090115000289
Entity NameMinuteclinic Diagnostic Medical Group Of Orange County Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1104013879
PECOS PAC ID: 5991868929
Enrollment ID: O20090116000214
Entity NameMinuteclinic Diagnostic Medical Group Of San Diego Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568659233
PECOS PAC ID: 2567520414
Enrollment ID: O20090127000249
Entity NameThe Davis Street Community Center Incorporated
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215358924
PECOS PAC ID: 6800956079
Enrollment ID: O20141204000241
Entity NameBay Area Pl Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932858628
PECOS PAC ID: 0143614305
Enrollment ID: O20220805002760

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ji Yeong Gendron Song is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ji Yeong Gendron Song,
738 Bancroft Road,
Walnut Creek, CA 94598

Ph: (925) 938-8525		Ji Yeong Gendron Song,
738 Bancroft Road,
Walnut Creek, CA 94598-1250

Ph: (925) 938-8525

Reviews and Comments


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Ms. Angela Christian, N.P.
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Reena Cho, FNP
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Practice Location: 110 Tampico Ste 210, Walnut Creek, CA 94598
Phone: 925-935-6952    Fax: 925-935-1396

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.