NPIMap

Individual provider Active NPI

Tristen Sinae Park, MD

  • Surgical Oncology Physician
  • New Haven, CT
National Provider Identifier
1295062081
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
56912 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 200-2328
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2016-00307 NC
General Acute Care Hospital 282N00000X MD037894 DC
Surgical Oncology Physician 2086X0206X 56912 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 200-2328

Other practice location 1

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240611002141 NY Practitioner - Surgical Oncology 1850421942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Columbia University College of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

10 Union Square E
Tisch Dept of Mount Sinai
New York, NY 10003-3314
Phone (212) 844-8288

325 W 15TH St
Tisch Dept of Mount Sinai
New York, NY 10011-5903
Phone (212) 367-1891

5 E 98TH St
Suite 6
New York, NY 10029-6501
Phone (212) 241-4812

5 E 98TH St 12TH Floor
Tisch Department of Mount Sinai
New York, NY 10029-6501
Phone (212) 241-8303

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281167NYMDLicensed Practical Nurse
2016-00307NCMDSurgery Physician
MD037894DCMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2024 Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
Fl 12
New York, NY 10029
Phone (212) 241-8303

Networks

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

Organizations & group practices 2

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 9

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295062081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-200-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-200-2328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "TRISTEN",
        "middle_name": "SINAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2016-00307",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DC",
            "license": "MD037894",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CT",
            "license": "56912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.