Individual provider Active NPI

Hoon Park, DO

  • Family Medicine Physician
  • Waxahachie, TX
National Provider Identifier
1043773674
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V2204 Issued in TX
Practice address
2460 N I 35 Ste 215
Waxahachie, TX 75165-5271
Phone
(972) 817-9570
NPI assigned
Apr 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X V2204 TX Primary

Addresses

Primary practice location

2460 N I 35 Ste 215
Waxahachie, TX 75165-5271

Mailing address

2460 N I 35 Ste 215
Waxahachie, TX 75165-5271
Phone (972) 817-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221006002181 TN Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5193052363 Reassigns benefits to 2 organizations
I20240820004723 TX Practitioner - Family Practice 5193052363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2460 N Ih 35E
215 Baylor Scott and White
Waxahachie, TX 75165-5271
Phone (469) 800-9830

Hospital & facility affiliations

  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
  • Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
V2204TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Sep 9, 2024 Accepting new patients
The Camellia Foundation Family Medicine CurrentSince Aug 22, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Sep 9, 2024 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Medicos General PLLC Family Medicine CurrentSince Aug 22, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients
Baylor Medical Center at Waxahachie Past Accepting new patients

Locations

3030 Covington Pike
Ste 100
Memphis, TN 38128
Phone (615) 277-0760

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2460 N Interstate Highway 35 E
Ste 215
Waxahachie, TX 75165
Phone (469) 800-9830

Interoperability endpoints

  • Direct secure messaging: hpark1327624@direct.sw.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1043773674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N I 35 STE 215",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655271",
            "telephone_number": "972-817-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N I 35 STE 215",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655271",
            "telephone_number": "972-817-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HOON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.