Individual provider Active NPI

Sehoon Park, MD

  • Orthopaedic Surgery Physician
  • Las Vegas, NV
National Provider Identifier
1164059903
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
29632 Issued in NV
Practice address
9321 W Sunset Rd
Las Vegas, NV 89148-4845
Phone
(702) 645-7800
Fax
(702) 650-0865
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 29632 NV Primary

Addresses

Primary practice location

9321 W Sunset Rd
Las Vegas, NV 89148-4845

Mailing address

9321 W Sunset Rd
Las Vegas, NV 89148-4845
Phone (702) 645-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20200811001321 NV Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 1254756042

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Nevada School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11035 Lavender Hill Dr
Suite 160 473
Las Vegas, NV 89135-2955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: spark1039715@direct.ahn.org

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1164059903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 W SUNSET RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484845",
            "telephone_number": "702-645-7800",
            "fax_number": "702-650-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9321 W SUNSET RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891484845",
            "telephone_number": "702-645-7800",
            "fax_number": "702-650-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SEHOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "29632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.