Individual provider Active NPI

Sumin Park, MD

  • Obstetrics & Gynecology Physician
  • East Norriton, PA
National Provider Identifier
1639675754
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD478427 Issued in PA
Practice address
609 W Germantown Pike Ste 220
East Norriton, PA 19403-4261
Phone
(484) 622-7940
Fax
(484) 622-7950
NPI assigned
Apr 5, 2018
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD478427 PA Primary

Addresses

Primary practice location

609 W Germantown Pike Ste 220
East Norriton, PA 19403-4261

Mailing address

609 W Germantown Pike Ste 220
East Norriton, PA 19403-4261
Phone (484) 622-7940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230307000729 PA Practitioner - Obstetrics/Gynecology 5496006538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fornance Physician Services IncGroup PAC ID 8527962661, 105 clinicians

Practice addresses (Care Compare)

609 W Germantown Pike
Suite 220
East Norriton, PA 19403-4261
Phone (484) 622-7940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD478427PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fornance Physician Services, Inc Obstetrics & Gynecology Current Accepting new patients
Fornance Physician Services, Inc. Obstetrics & Gynecology CurrentSince Nov 15, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 1, 2026 Accepting new patients
Fornance Physician Services, Inc. CurrentSince Nov 15, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 1, 2026 Accepting new patients
Einstein Medical Center Montgomery Past Accepting new patients

Locations

210 Mall Blvd
Ste 203
King of Prussia, PA 19406
Phone (484) 622-7940

1330 Powell St
Ste 507
Norristown, PA 19401
Phone (484) 622-7300

609 W Germantown Pike
Ste 220
Norristown, PA 19403
Phone (484) 622-7940

5401 Old York Rd
Ste 331
Philadelphia, PA 19141
Phone (215) 456-6948

Organizations & group practices 7

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 1

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1639675754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 W GERMANTOWN PIKE STE 220",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034261",
            "telephone_number": "484-622-7940",
            "fax_number": "484-622-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 W GERMANTOWN PIKE STE 220",
            "city": "EAST NORRITON",
            "state": "PA",
            "postal_code": "194034261",
            "telephone_number": "484-622-7940",
            "fax_number": "484-622-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD478427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Norriton, PA

Sources for this page

Verify at the official NPI Registry.