Active NPI
Sung Woong Park
- Internal Medicine Physician
- Clermont, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME163770
- Practice address
- 1900 Don Wickham Dr
Clermont, FL 34711-1979 - Phone
- (525) 368-8303
- Fax
- (352) 236-8841
- NPI assigned
- Mar 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME163770 | FL | Primary |
| Internal Medicine Physician | 207R00000X | 2022-00792 | NC |
Addresses
Primary practice location
1900 Don Wickham Dr
Clermont, FL 34711-1979
Mailing address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8830
Other practice location 1
2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494
Phone (919) 587-4394
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | spark170257@direct.UNC.nchie.net | Direct | |
| Other URL | providerenrollment@orlandohealth.com | ||
| Other URL | providerenrollment@orlandohealth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840
Hospital & facility affiliations
- Orlando Health South Lake Hospital
- Uf Health Leesburg Hospital
- Orlando Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME163770 | FL | MD | Internal Medicine Physician |
| 2022-00792 | NC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unc Physicians Network LLC | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Unc Physicians Network LLC | Internal Medicine | Current | Accepting new patients |
| Orlando Health Medical Group Inc | Internal Medicine | Current | Accepting new patients |
Locations
1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761
32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820
940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123
2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060
5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
- Family Medicine Physician
- Pittsboro, NC
- NPI 1750704367
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
-
- General Practice Physician
- Morrisville, NC
- NPI 1558786830
Internal Medicine
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Leesburg, FL
- NPI 1245226190
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1184709057
-
- General Acute Care Hospital
- Clermont, FL
- NPI 1336221019
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1033670914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 DON WICKHAM DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347111979",
"telephone_number": "352-536-8830",
"fax_number": "352-536-8841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 DON WICKHAM DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347111979",
"telephone_number": "525-368-8303",
"fax_number": "352-236-8841"
}
],
"practiceLocations": [
{
"address_1": "2700 Wayne Memorial Dr",
"address_purpose": "LOCATION",
"city": "Goldsboro",
"state": "NC",
"postal_code": "275349494",
"country_code": "US",
"telephone_number": "919-587-4394",
"fax_number": "919-587-2998",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "SUNG",
"middle_name": "WOONG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-25",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME163770",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "2022-00792",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "spark170257@direct.UNC.nchie.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "2700 Wayne Memorial Dr",
"city": "Goldsboro",
"state": "NC",
"country_code": "US",
"postal_code": "275349494",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "providerenrollment@orlandohealth.com",
"affiliation": "N",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1900 Don Wickham Dr",
"city": "Clermont",
"state": "FL",
"country_code": "US",
"postal_code": "347111979",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "providerenrollment@orlandohealth.com",
"affiliation": "N",
"address_1": "1900 Don Wickham Dr",
"city": "Clermont",
"state": "FL",
"country_code": "US",
"postal_code": "347111979",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.