Individual provider Active NPI

Hoon Jae Park, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Wappingers Falls, NY
National Provider Identifier
1235135542
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
168538 Issued in NY
Practice address
1772 South Rd
Wappingers Falls, NY 12590-1361
Phone
(845) 298-6060
Fax
(845) 298-0901
NPI assigned
Jun 22, 2005
Last updated
Dec 11, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 168538 NY Primary

Addresses

Primary practice location

1772 South Rd
Wappingers Falls, NY 12590-1361

Mailing address

1772 South Rd
Wappingers Falls, NY 12590-1361
Phone (845) 298-6060

Other identifiers 2

IdentifierTypeStateIssuer
08F602OtherNYBC/BS
497001OtherNYMVP

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
I20100323000116 NY Practitioner - Physical Medicine and Rehabilitation 7517092059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1315 Route 9
Suite 205
Wappingers Falls, NY 12590-4978
Phone (845) 298-6060

Merit-based Incentive Payment System (MIPS)

Final score
84.92 of 100Reported as group
Quality
68.46
Promoting interoperability
99
Improvement activities
40
Cost
77.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
168538NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middletown Medical PC CurrentSince Dec 9, 2022 Accepting new patients
Hoon J Park MD PC CurrentSince Jan 5, 2010 Accepting new patients
Middletown Medical PC CurrentSince Dec 9, 2022 Accepting new patients

Locations

111 Maltese Dr
Middletown, NY 10940

1315 Route 9
Ste 205
Wappingers Fl, NY 12590
Phone (845) 297-4055

1772 South Rd
Wappingers Fl, NY 12590
Phone (845) 298-6060

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEAABA/Endpoint/DEAABA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1235135542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 SOUTH RD",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901361",
            "telephone_number": "845-298-6060",
            "fax_number": "845-298-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 SOUTH RD",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125901361",
            "telephone_number": "845-298-6060",
            "fax_number": "845-298-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HOON",
        "middle_name": "JAE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "168538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "08F602",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "497001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

Verify at the official NPI Registry.