NPIMap

Individual provider Active NPI

Hyon Ju Park, MD

  • Rheumatology Physician
  • Wynnewood, PA
National Provider Identifier
1083810048
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD448227 Issued in PA
Practice address
137 Lankenau Medical Building W
Wynnewood, PA 19096-3453
Phone
(610) 896-8400
Fax
(610) 896-9652
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007017292 MO
Rheumatology Physician 207RR0500X C1-0011316 DE
Rheumatology Physician 207RR0500X MD448227 PA Primary

Addresses

Primary practice location

137 Lankenau Medical Building W
Wynnewood, PA 19096-3453

Mailing address

200 Hygeia Dr
CCHS Physician Contracting, Suite 2300
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130826000098 PA Practitioner - Rheumatology 6608019518 Reassigns benefits to 2 organizations
I20150602000625 DE Practitioner - Rheumatology 6608019518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Icahn School of Medicine at Mount Sinai, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007017292MOMDInternal Medicine Physician
C1-0011316DEMDRheumatology Physician
MD448227PAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services Inc CurrentSince Jul 6, 2015 Accepting new patients
Bryn Mawr Medical Specialists Association CurrentSince Jan 1, 2021 Accepting new patients
Christiana Care Health Services Inc. Rheumatology CurrentSince Jul 6, 2015 Accepting new patients
Gary Gordon Rheumatology PastSince Jun 28, 2020 Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 2201
Newark, DE 19713
Phone (302) 320-2490

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

501 W 14th St
Bldg 5TH
Wilmington, DE 19801
Phone (302) 320-2620

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

3301 Lancaster Pike
Ste 9
Wilmington, DE 19805
Phone (302) 320-4569

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

100 E Lancaster Ave
Ste 137
Wynnewood, PA 19096
Phone (610) 896-8400

Interoperability endpoints

  • Direct secure messaging: hyonju.park@bmmsa.directbygreenway.com

Organizations & group practices 6

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 6

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1083810048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR",
            "address_2": "CCHS PHYSICIAN CONTRACTING, SUITE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 LANKENAU MEDICAL BUILDING W",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-896-8400",
            "fax_number": "610-896-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYON JU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2007017292",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "DE",
            "license": "C1-0011316",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD448227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.