Individual provider Active NPI

Saung Z Park, MD

  • Surgery Physician
  • Little Falls, MN
National Provider Identifier
1376512186
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
38468 Issued in MN
Practice address
811 2ND St SE
Suite a
Little Falls, MN 56345-3559
Phone
(320) 631-7000
Fax
(320) 632-0534
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X L8467 TX
Surgery Physician 208600000X 38468 MN Primary

Addresses

Primary practice location

811 2ND St SE
Suite a
Little Falls, MN 56345-3559

Mailing address

811 2ND St SE
Suite a
Little Falls, MN 56345-3559
Phone (320) 631-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metroplex Clinic Physicians, Inc. PastSince Oct 9, 2012 Accepting new patients
Camino Real Emergency Physicians PLLC Past Accepting new patients
Ellis Emergency Group PA Past Accepting new patients
Houston Emergency Medicine Associates PA Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients
Cherokee Emergency Medicine Associates PA Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1376512186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 2ND ST SE",
            "address_2": "SUITE A",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453559",
            "telephone_number": "320-631-7000",
            "fax_number": "320-632-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 2ND ST SE",
            "address_2": "SUITE A",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453559",
            "telephone_number": "320-631-7000",
            "fax_number": "320-632-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAUNG",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "L8467",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "38468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.