Individual provider Active NPI

Myung Hee Park, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Tacoma, WA
National Provider Identifier
1205875986
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
MD60931616 Issued in WA
Practice address
1802 Yakima Ave Ste 302
Tacoma, WA 98405-5305
Phone
(253) 627-1244
Fax
(253) 274-7993
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD60931616 WA
Cardiovascular Disease Physician 207RC0000X D63218 MD
Cardiovascular Disease Physician 207RC0000X Q4238 TX
Interventional Cardiology Physician 207RI0011X D63218 MD
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X MD60931616 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 302
Tacoma, WA 98405-5305

Mailing address

1802 Yakima Ave Ste 302
Tacoma, WA 98405-5305
Phone (253) 627-1244

Other practice location 1

6550 Fannin St
Suite 1401
Houston, TX 77030-2717
Phone (713) 441-1100

Other practice location 2

2709 Hemlock St
Bremerton, WA 98310-2623
Phone (360) 782-6000

Other identifiers 5

IdentifierTypeStateIssuer
647078-01OtherMDBLUE CROSS/BLUE SHIELD
8FC783OtherTXBLUE CROSS BLUE SHIELD
349207601MedicaidTX
408288500MedicaidMD
2130874MedicaidWA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mpark482451@fhsce.catholichealth.net
Direct Messaging Address mpark482451@fhsce.catholichealth.net
Direct Messaging Address mpark482451@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150701000619 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Advanced Heart Failure and Transplant Cardiology 4981696960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
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

State licenses

LicenseStateTypeSpecialty
Q4238TXMDCardiovascular Disease Physician
MD60931616WAMDCardiovascular Disease Physician
45068TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physician Associates PLLC CurrentSince Nov 1, 2016 Accepting new patients
TMH Physician Associates PLLC CurrentSince Nov 1, 2016 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

6550 Fannin St
Ste 1401
Houston, TX 77030
Phone (713) 441-5200

6550 Fannin St
Ste 1150
Houston, TX 77030
Phone (713) 441-2670

6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1205875986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 302",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-274-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 302",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-274-7993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6550 Fannin St",
            "address_2": "Suite 1401",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302717",
            "country_code": "US",
            "telephone_number": "713-441-1100",
            "fax_number": "713-790-2643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2709 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Bremerton",
            "state": "WA",
            "postal_code": "983102623",
            "country_code": "US",
            "telephone_number": "360-782-6000",
            "fax_number": "360-782-6099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "MYUNG",
        "middle_name": "HEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60931616",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MD",
            "license": "D63218",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "Q4238",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MD",
            "license": "D63218",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "WA",
            "license": "MD60931616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "647078-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8FC783",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349207601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408288500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2130874",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpark482451@fhsce.catholichealth.net",
            "affiliation": "N",
            "address_1": "1802 Yakima Ave Ste 302",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpark482451@fhsce.catholichealth.net",
            "affiliation": "N",
            "address_1": "2709 Hemlock St",
            "city": "Bremerton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983102623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpark482451@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 302",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.