Hyoungsup Park, M.D., PHD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

043254 Issued in CT

Practice address

599 Famington Ave
Farmington, CT 06032

Phone

(608) 284-4945

Fax

(860) 284-4946

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Dr. H Stephen Park Professional name

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hyoungsup.park.npi1174512735.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment NPD
• Mwa, PC

  • Sleep Disorder Diagnostic Clinic/Center
  • Chicopee, MA
  • NPI 1427280791
  NPD (past)
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1639280779
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1174512735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 FAMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "608-284-4945",
            "fax_number": "860-284-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 FAMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06032",
            "telephone_number": "608-284-4945",
            "fax_number": "860-284-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYOUNGSUP",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "223132",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "200492",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "043254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008004410",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H",
            "last_name": "PARK",
            "middle_name": "STEPHEN",
            "prefix": "DR.",
            "credential": "M.D., PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ritesh Pravin Parekh, MD
• Kourosh Parham, MD
• Neil D Parikh, M.D.
• Raina Parikh, MD
• Anusha Parisapogu, MBBS
• Sangmo Park, M.D
• Charlet Parker, RN
• Manraj Singh Parmar, M.D.
• Anthony Parrino, M.D.
• Matthew Partan, DO

• Family Medicine Physician in Farmington, CT
• Providers in Farmington, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.