Sae-Lyoung Park, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N006468 Issued in NY

Practice address

143-08 Roosevelt Ave.
Apt L4
Flushing, NY 11354

Phone

(718) 939-3220

Fax

(718) 939-3440

NPI assigned

Mar 14, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: saelyoungpark@whmc.allscriptsdirect.net

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.

• Comfort Step Podiatry, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Flushing, NY
  • NPI 1437924503
  NPD Authorized official
• Wyckoff Heights Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1700886322
  NPD

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1609141373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143-08 ROOSEVELT AVE.",
            "address_2": "APT L4",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-939-3220",
            "fax_number": "718-939-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143-08 ROOSEVELT AVE.",
            "address_2": "APT L4",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "718-939-3220",
            "fax_number": "718-939-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAE-LYOUNG",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-14",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03581459",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1609141373",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minseo Park
• Miyoung Park
• No Tae Park
• Olivia Park, PHARMD
• Rana Park
• Sang Ho Park, D.C.
• Sang Jun Park, LAC
• So-Youn Park
• Sojeung Park, PHARMD
• Soyul Park

• Foot & Ankle Surgery Podiatrist in Flushing, NY
• Providers in Flushing, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.