Sangdo Park, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A107642 Issued in CA

Practice address

2105 Beverly Blvd
Suite 223
Los Angeles, CA 90057-2216

Phone

(213) 989-0644

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Orthopedic Surgery

Education

Columbia University College of Physicians and Surgeons, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cross Care, Inc Home health agency, Los Angeles, CA, CCN 059383
• Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
• Hollywood Presbyterian Medical Center Hospital, Los Angeles, CA, CCN 050063

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Sangdo Park, M.D., a Professional Corporation

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Los Angeles, CA
  • NPI 1346590098
  Medicare reassignment NPD Authorized official
• Cha Hollywood Medical Center, LP

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  NPD (past)
• Good Samaritan Hospital, L.P.

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1376595777
  NPD (past)
• Metrocrest Orthopaedics & Sports Medicine

  • Specialist
  • Carrollton, TX
  • NPI 1710030374
  NPD (past)
• North Star FM, LP

  • Radiology Clinic/Center
  • Flower Mound, TX
  • NPI 1174812028
  NPD (past)
• Texas Health Presbyterian Hospital Plano

  • Psychiatric Hospital Unit
  • Plano, TX
  • NPI 1104982511
  NPD (past)

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

• Cha Hollywood Medical Center, LP

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  Care Compare affiliation
• Cross Care, Inc

  • Home Health Agency
  • Los Angeles, CA
  • NPI 1104132216
  Care Compare affiliation
• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  Care Compare affiliation

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1164582656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 223",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-989-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 BEVERLY BLVD",
            "address_2": "SUITE 223",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900572216",
            "telephone_number": "213-989-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANGDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "N6562",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A107642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8W9051",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS TX - EFFECT. 02/01/2011",
            "identifier": "8CR159",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00935331",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sang Park
• Sang Hyo Park, MD
• Sang Jin Park, PHARMACIST
• Sang Kyu Park
• Sang Woo Park, O.M.D.
• Sangji Emily Park, LMFT
• Sara Soyoung Park, PHARM.D.
• Sarah Eugene Park, MD
• Sarah H. Park
• SE Jin Park

• Sports Medicine (Orthopaedic Surgery) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.