NPIMap

Individual provider Active NPI

Chong S Park, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Clairton, PA
National Provider Identifier
1275526477
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD-053162-L Issued in PA
Practice address
575 Coal Valley Rd
Ste 504
Clairton, PA 15025-3730
Phone
(412) 469-7900
Fax
(412) 469-7919
NPI assigned
Aug 24, 2005
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD-053162-L PA Primary

Addresses

Primary practice location

575 Coal Valley Rd
Ste 504
Clairton, PA 15025-3730

Mailing address

575 Coal Valley Rd
Ste 504
Clairton, PA 15025-3730
Phone (412) 469-7900

Other identifiers 1

IdentifierTypeStateIssuer
0016361900003MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpark73157@direct.ahn.org

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
I20100827000336 PA Practitioner - Cardiac Surgery 3870617871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Hahnemann University College of Medicine, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

575 Coal Valley Rd
Suite 504
Clairton, PA 15025-3730

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-053162-LPAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Cardiothoracic and Vascular Institute Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 1, 1997 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Canonsburg General Hospital PastSince Jan 1, 2025 Accepting new patients

Locations

575 Coal Valley Rd
Ste 504
Jefferson Hls, PA 15025
Phone (412) 469-7900

80 Matthew Dr
Ste 3001
Uniontown, PA 15401
Phone (724) 873-1117

Interoperability endpoints

  • Direct secure messaging: cpark73157@direct.ahn.org

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jefferson HospitalPittsburgh, PA, CCN 390265 Hospital Corporate Officer Jul 1, 2020
Canonsburg HospitalCanonsburg, PA, CCN 390160 Hospital Corporate Officer
Corporate Director		 Jan 1, 2025
Jan 1, 2025
Jefferson Regional Medical CenterJefferson Hills, PA, CCN 39S265 Hospital Corporate Officer
Corporate Director		 Jan 1, 2021
Jan 1, 2021
Canonsburg HospitalCanonsburg, PA, CCN 39T160 Hospital Corporate Officer Jan 1, 2025
Jefferson Regional Medical CenterJefferson Hills, PA, CCN 39T265 Hospital Corporate Officer
Corporate Director		 Jan 1, 2021
Jan 1, 2021

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

Hospital & facility affiliations 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1275526477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD",
            "address_2": "STE 504",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150253730",
            "telephone_number": "412-469-7900",
            "fax_number": "412-469-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD",
            "address_2": "STE 504",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150253730",
            "telephone_number": "412-469-7900",
            "fax_number": "412-469-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHONG",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD-053162-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016361900003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpark73157@direct.ahn.org",
            "affiliation": "N",
            "address_1": "575 Coal Valley Rd",
            "address_2": "Ste 504",
            "city": "Clairton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150253730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clairton, PA

Sources for this page

Verify at the official NPI Registry.