David D. Park, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

032801 Issued in GA

Practice address

5673 Peachtree Dunwoody Rd NE
Suite 300
Atlanta, GA 30342-1731

Phone

(404) 252-6118

Fax

(404) 252-8016

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

General Surgery

Education

University of Missouri, Columbia School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Surgical Specialists LLCGroup PAC ID 8921359977, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.park.1@17177.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/17177/brand/1/csg/1/fhir/r4

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.

• Park Surgical Specialists, LLC

  • Specialist
  • Suwanee, GA
  • NPI 1083122055
  Medicare reassignment Care Compare group NPD
• Tift Regional Health System Inc

  dba Tift Regional Ophthalmology

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Tift Regional Health System Inc

  dba South GA Surgical

  • Surgery Physician
  • Tifton, GA
  • NPI 1912315094
  NPD

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

• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1114986569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 NEW PEACHTREE RD",
            "address_2": "SUITE 202",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303413326",
            "telephone_number": "678-336-5951",
            "fax_number": "678-336-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-252-6118",
            "fax_number": "404-252-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "032801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Chul Park, O.D.
• Benjamin Park, MD
• Catherine Park, M.D.
• Chai Park, OTD, OTR/L
• Chong Yop Park, RPH
• Eunhye Park
• Hailey Kyung Yeon Park, DDS
• Jae Yeon Park, DMD
• James Park, D.M.D
• Jasmine Jungmin Park, D.O.

• Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.