Individual provider Active NPI

Eunhae Park, MD

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1174518922
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
217656-1 Issued in NY
Practice address
445 Lenox Rd
Brooklyn, NY 11203-2017
Phone
(718) 245-4790
NPI assigned
Sep 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 217656-1 NY Primary

Addresses

Primary practice location

445 Lenox Rd
Brooklyn, NY 11203-2017

Mailing address

445 Lenox Rd
Brooklyn, NY 11203-2017
Phone (718) 245-4790

Other identifiers 1

IdentifierTypeStateIssuer
02152101MedicaidNY

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
I20110426000168 NY Practitioner - Emergency Medicine 3678758273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

470 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217656-1NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Current Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 1, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Emergency Medicine CurrentSince Jan 1, 2022 Accepting new patients
Suny Health Science Center at Bklyn Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients

Locations

840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

445 Lenox Rd
Brooklyn, NY 11203
Phone (718) 245-4790

450 Clarkson Ave
#59
Brooklyn, NY 11203
Phone (718) 270-2078

445 Lenox Rd
#71
Brooklyn, NY 11203
Phone (718) 270-2030

Organizations & group practices 4

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 1

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174518922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 LENOX RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032017",
            "telephone_number": "718-245-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 LENOX RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032017",
            "telephone_number": "718-245-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EUNHAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "217656-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02152101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.