Susan Jin-Sun Park, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

13322 Issued in NV

Practice address

661 Sierra Rose Dr
Reno, NV 89511

Phone

(775) 982-8255

Fax

(775) 982-8251

NPI assigned

Jul 14, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Sports Medicine

Education

University of Nevada School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Hometown Health Management CompanyGroup PAC ID 0244139798, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
• Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049

Merit-based Incentive Payment System (MIPS)

Final score

86.15 of 100Reported as group

Quality

78.17

Promoting interoperability

100

Improvement activities

40

Cost

75.68

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spark19071@direct.renown.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hometown Health Management Company

  • Family Medicine Physician
  • Sparks, NV
  • NPI 1861445892
  Medicare reassignment Care Compare group NPD
• Hometown Health Management Company

  • Family Medicine Physician
  • Reno, NV
  • NPI 1841761277
  NPD
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation
• Renown South Meadows Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1720058027
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1003070640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MCM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 SIERRA ROSE DR",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89511",
            "telephone_number": "775-982-8255",
            "fax_number": "775-982-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "middle_name": "JIN-SUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NV",
            "license": "13322",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A98140",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "13322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12139950",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Park, APRN
• Paul J Park, MD
• Seung Bai Park, O.M.D.
• Somakhanden Park, MI4032 AND CI5055
• Soonjin Park, DDS
• Alan Parker
• Bobbi-Jo C Parker
• Chauncey R. Parker IV, PH.D.
• Darryl Pernell Parker Jr., MASSAGE THERAPIST
• Jamie Jo Parker, NP

• Family Medicine Physician in Reno, NV
• Providers in Reno, NV by specialty
• Family Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.