Individual provider Active NPI

Dong Chul Park, MD

  • Neurology Physician
  • Bel Air, MD
National Provider Identifier
1174794788
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D71072 Issued in MD
Practice address
520 Upper Chesapeake Dr
Ste 208
Bel Air, MD 21014-4339
Phone
(443) 643-3335
NPI assigned
Mar 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101242765 VA
Neurology Physician 2084N0400X D71072 MD Primary

Addresses

Primary practice location

520 Upper Chesapeake Dr
Ste 208
Bel Air, MD 21014-4339

Mailing address

520 Upper Chesapeake Dr
Ste 208
Bel Air, MD 21014-4339
Phone (443) 643-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110318000369 MD Practitioner - Neurology 3678645165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harford Neurology Associates PAGroup PAC ID 0143240358, 3 clinicians

Practice addresses (Care Compare)

520 Upper Chesapeake Dr
Suite 208
Bel Air, MD 21014-4392
Phone (443) 643-3335

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.54 of 100Reported as group
Quality
46.97
Improvement activities
40
Cost
94.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D71072MDMDNeurology Physician
0101242765VAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harford Neurology Associates P.a. Neurology CurrentSince Jan 1, 2011 Accepting new patients
Union Hospital of Cecil County Neurology CurrentSince Jul 1, 2018 Accepting new patients

Locations

520 Upper Chesapeake Dr
Ste 208
Bel Air, MD 21014
Phone (443) 643-3335

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Interoperability endpoints

  • Direct secure messaging: dpark533508@direct.umm.edu

Organizations & group practices 2

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 5

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": "1206144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1174794788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "STE 208",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "443-643-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "STE 208",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "443-643-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DONG CHUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-22",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101242765",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D71072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.