Individual provider Active NPI

Hyeyoung Yeom Park, MD

  • Physical Medicine & Rehabilitation Physician
  • Las Vegas, NV
National Provider Identifier
1639638794
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
23857 Issued in NV
Practice address
840 S Rancho Dr Ste 4-740
Las Vegas, NV 89106-3837
Phone
(702) 242-6911
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 23857 NV Primary

Addresses

Primary practice location

840 S Rancho Dr Ste 4-740
Las Vegas, NV 89106-3837

Mailing address

840 S Rancho Dr Ste 4-740
Las Vegas, NV 89106-3837
Phone (702) 242-6911

Other names 1

  • Hyeyoung Yeom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20231004003249 NV Practitioner - Physical Medicine and Rehabilitation 0244566784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Physical Medicine and Rehabilitation PCGroup PAC ID 9133479546, 27 clinicians

Practice addresses (Care Compare)

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (702) 961-5000

Hospital & facility affiliations

  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047
  • Sunrise Hospital Medical Center Inpatient rehabilitation facility, Las Vegas, NV, CCN 29T003

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Physical Medicine and Rehabilitation PC Physical Medicine & Rehabilitation CurrentSince Sep 21, 2023 Accepting new patients

Locations

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

840 S Rancho Dr
Ste 4740
Las Vegas, NV 89106
Phone (702) 242-6911

Interoperability endpoints

  • Direct secure messaging: hyeyoung.park@hca3.eclinicaldirectplus.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1639638794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S RANCHO DR STE 4-740",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063837",
            "telephone_number": "702-242-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S RANCHO DR STE 4-740",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063837",
            "telephone_number": "702-242-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYEYOUNG",
        "middle_name": "YEOM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NV",
            "license": "23857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HYEYOUNG",
            "last_name": "YEOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.