Individual provider Active NPI

Won Sik Park

  • Emergency Medicine Physician
  • Huntington, NY
National Provider Identifier
1134879638
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
333469-01 Issued in NY
Practice address
270 Park Ave
Huntington, NY 11743-2787
Phone
(631) 351-2000
NPI assigned
Mar 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 333469-01 NY Primary

Addresses

Primary practice location

270 Park Ave
Huntington, NY 11743-2787

Mailing address

9233 246TH St
Floral Park, NY 11001-3920
Phone (646) 599-5943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20250307001277 NY Practitioner - Emergency Medicine 9739600610 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Pennsylvania State University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6000

Hospital & facility affiliations

  • Huntington Hospital Dialysis facility, Huntington, NY, CCN 332310
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333469-01NYMDEmergency Medicine Physician

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
John T. Mather Memorial Hospital Emergency Medicine CurrentSince Feb 19, 2025 Accepting new patients
John T. Mather Memorial Hospital Current Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Apr 24, 2025 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Feb 19, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Apr 24, 2025 Accepting new patients

Locations

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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 3

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": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1134879638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 246TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110013920",
            "telephone_number": "646-599-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432787",
            "telephone_number": "631-351-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "WON SIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "333469-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.