Hyeun S Park, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

25MA08032900 Issued in NJ

Practice address

415 Boulevard
Mountain Lakes, NJ 07046

Phone

(973) 334-7700

Fax

(973) 334-7116

NPI assigned

Oct 6, 2006

Last updated

Aug 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• NJ Urgentcare

  • Urgent Care Clinic/Center
  • Elizabeth, NJ
  • NPI 1790381572
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1235226960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BOULEVARD",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "07046",
            "telephone_number": "973-334-7700",
            "fax_number": "973-334-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BOULEVARD",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "07046",
            "telephone_number": "973-334-7700",
            "fax_number": "973-334-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYEUN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08032900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "25MA08032900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Catherine O'Neill, L.A.C.
• Oncology & Hematology Specialists,P.a.
• Darlene M Osipuk, MD
• Panacea Id Health LLC
• Christopher George Parigoris, PSY.D.
• Joo Hyoung Park
• John Anton Parkinson Jr., OT
• Peter Dabrowski M.D. PC
• Piece by Piece Therapeutics
• Podias Enterprises LLC Dba Synergy Home Care (SYNERGY Home Care)

• Cardiovascular Disease Physician in Mountain Lakes, NJ
• Providers in Mountain Lakes, NJ by specialty
• Cardiovascular Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.