Susan Ahn Park, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

232798-1 Issued in NY

Practice address

155 E 76TH St
New York, NY 10021-2810

Phone

(646) 801-7837

Fax

(646) 351-0685

NPI assigned

Jan 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Manhattan Medical Physician PLLC

  dba Susan Park, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1780994913
  NPD (past) Authorized official
• The Westchester Medical Group PC

  dba Westmed Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Greenwich, CT
  • NPI 1790560878
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1467431965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212810",
            "telephone_number": "646-801-7837",
            "fax_number": "646-351-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212810",
            "telephone_number": "646-801-7837",
            "fax_number": "646-351-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUSAN",
        "middle_name": "AHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "232798-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung Min Park
• Sunha Park
• Sunho Park
• Sunmin Park, LMSW
• Sunwoo Park, MD
• Susan S Park, DDS
• Susan Suh Young Park, M.D.
• Susie Park
• Thomas Park
• Tina Park, M.D.

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.