Individual provider Active NPI

Wonhoon Park, MD

  • Psychiatry Physician
  • Buffalo, NY
National Provider Identifier
1114925088
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
137143 Issued in NY
Practice address
80 Goodrich St
Buffalo, NY 14203-1005
Phone
(716) 859-1677
NPI assigned
Jul 13, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 137143 NY Primary

Addresses

Primary practice location

80 Goodrich St
Buffalo, NY 14203-1005

Mailing address

80 Goodrich St
Buffalo, NY 14203-1005
Phone (716) 859-1677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040225000065 NY Practitioner - Psychiatry 5991604688 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Niagara Falls Memorial Medical Center CurrentSince Sep 15, 2015 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Sep 15, 2015 Accepting new patients
University Psychiatric Practice, Inc Psychiatry CurrentSince Sep 3, 2013 Accepting new patients
Niagara Falls Memorial Medical Center CurrentSince Sep 15, 2015 Accepting new patients
Horizon Health Services Inc PastSince Sep 1, 2019 Accepting new patients
Erie County South East Corp V PastSince Mar 3, 2009 Accepting new patients

Locations

462 Grider St
Rm 1168
Buffalo, NY 14215
Phone (716) 898-4857

620 10th St
Ste 704
Niagara Falls, NY 14301
Phone (716) 278-4402

621 10th St
North Falls, NY 14301
Phone (716) 278-4000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/
  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114925088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 GOODRICH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031005",
            "telephone_number": "716-859-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GOODRICH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031005",
            "telephone_number": "716-859-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "WONHOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "137143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.