Individual provider Active NPI

Lisa Park, M.D.

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1356401228
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
211933 Issued in NY
Practice address
635 W 165TH St
New York, NY 10032-3724
Phone
(212) 305-9535
Fax
(212) 305-5523
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 211933 NY Primary

Addresses

Primary practice location

635 W 165TH St
New York, NY 10032-3724

Mailing address

635 W 165TH St
Harkness Eye Institute
New York, NY 10032-3724
Phone (212) 305-6709

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
I20040806001219 NY Practitioner - Ophthalmology 0244202604 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Yale University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, shared by 10 NPIs, 2,262 clinicians

Practice addresses (Care Compare)

161 Fort Washington Ave
New York, NY 10032-3729
Phone (212) 305-8559

635 W 165TH St
New York, NY 10032-3797
Phone (212) 305-5994

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery293

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211933NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Ophthalmology CurrentSince Apr 1, 2018 Accepting new patients
Harlem Medical Associates PC CurrentSince Oct 27, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Feb 18, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Ophthalmology CurrentSince Feb 18, 2017 Accepting new patients
New York University CurrentSince Oct 1, 2009 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients
New York University Past Accepting new patients
Manhattan Eye Ear and Throat Hospital Past Accepting new patients
New York University Student Health Center Past Accepting new patients

Locations

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

210 E 64th St
New York, NY 10065
Phone (212) 434-4312

530 1st Ave
New York, NY 10016
Phone (212) 263-7216

530 1st Ave
Ste 3B
New York, NY 10016
Phone (212) 263-2573

530 1st Ave
Rm Hcc
New York, NY 10016

635 W 165th St
New York, NY 10032
Phone (212) 305-3039

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

160 E 32nd St
#2
New York, NY 10016
Phone (212) 263-5940

880 3rd Ave
New York, NY 10022
Phone (212) 305-5289

530 1st Ave
Ste HCC3B
New York, NY 10016
Phone (212) 263-2573

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Interoperability endpoints

  • Direct secure messaging: lip9076@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 9

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 5

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1356401228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "address_2": "HARKNESS EYE INSTITUTE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-6709",
            "fax_number": "212-305-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-9535",
            "fax_number": "212-305-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "211933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.