NPIMap

Individual provider Active NPI

Sangkun Park, MD

  • Internal Medicine Physician
  • Astoria, OR
National Provider Identifier
1477622991
Registry record updated Feb 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18585 Issued in OR
Practice address
2120 Exchange St
Ste 200
Astoria, OR 97103-3364
Phone
(503) 325-5360
Fax
(503) 325-9373
NPI assigned
Nov 7, 2006
Last updated
Feb 25, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD18585 OR Primary
Bone Densitometry Radiologic Technologist 2471B0102X
Radiography Radiologic Technologist 2471C3402X

Addresses

Primary practice location

2120 Exchange St
Ste 200
Astoria, OR 97103-3364

Mailing address

2120 Exchange St
Ste 200
Astoria, OR 97103-3364
Phone (503) 325-5360

Other identifiers 2

IdentifierTypeStateIssuer
061320MedicaidOR
1091644MedicaidWA

Other names 1

  • Sonny Park Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20100802000399 OR Practitioner - Internal Medicine 8426076738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wright State University Boonshoft School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2120 Exchange St
Suite 200
Astoria, OR 97103-3364
Phone (503) 325-5360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.44 of 100Reported as group
Quality
87
Promoting interoperability
100
Improvement activities
40
Cost
73.18

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
62.39
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.88 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
76.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18585ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonny Park PC Internal Medicine CurrentSince Jan 8, 2001 Accepting new patients

Locations

2120 Exchange St
Ste 200
Astoria, OR 97103
Phone (360) 501-3400

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/7d7f9694-46c9-4670-abeb-9400514e3b75/

Organizations & group practices 1

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 10

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235520000000",
    "number": "1477622991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST",
            "address_2": "STE 200",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033364",
            "telephone_number": "503-325-5360",
            "fax_number": "503-325-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 EXCHANGE ST",
            "address_2": "STE 200",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033364",
            "telephone_number": "503-325-5360",
            "fax_number": "503-325-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANGKUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD18585",
            "primary": true
        },
        {
            "code": "2471B0102X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061320",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091644",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONNY",
            "last_name": "PARK",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.