NPIMap

Individual provider Active NPI

So Hyang Park, MD

  • Hematology & Oncology Physician
  • Ephrata, PA
National Provider Identifier
1205974706
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD062484L Issued in PA
Practice address
460 N Reading Rd
Ephrata, PA 17522-9606
Phone
(717) 738-4070
Fax
(717) 738-3558
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MD062484L PA Primary

Addresses

Primary practice location

460 N Reading Rd
Ephrata, PA 17522-9606

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 721-4840

Other identifiers 1

IdentifierTypeStateIssuer
01919427MedicaidPA

Other names 1

  • Dr. So Hyang Park Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000345 PA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 0244364719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Physician ServicesGroup PAC ID 5496728172, 102 clinicians

Practice addresses (Care Compare)

460 N Reading Rd
Wellspan Medical Oncology and Hematology
Ephrata, PA 17522-9606
Phone (717) 721-4840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Physician Services CurrentSince Mar 1, 2024 Accepting new patients
Good Samaritan Physician Services Current Accepting new patients
Good Samaritan Physician Services CurrentSince Mar 1, 2024 Accepting new patients

Locations

460 N Reading Rd
Ephrata, PA 17522
Phone (717) 721-4840

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

844 Tuck St
Lebanon, PA 17042
Phone (717) 274-8875

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: spark38931@wellspan.direct-ci.com

Organizations & group practices 3

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 11

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1205974706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-721-4840",
            "fax_number": "717-738-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N READING RD",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229606",
            "telephone_number": "717-738-4070",
            "fax_number": "717-738-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SO",
        "middle_name": "HYANG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "PA",
            "license": "MD062484L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01919427",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SO HYANG",
            "last_name": "PARK",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.