Sung-Un Justin Park, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A48704 Issued in CA

Practice address

3055 W Orange Ave
Suite 101
Anaheim, CA 92804

Phone

(714) 484-8054

Fax

(714) 484-8072

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

NeurologyAlso: Pain Management

Education

Other, 1988

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Divine Home Health, Inc Home health agency, La Mirada, CA, CCN 058330
• Ace Home Health, Inc. Home health agency, Los Angeles, CA, CCN 058082

Merit-based Incentive Payment System (MIPS)

Final score

47.84 of 100Reported as individual

Quality

37.34

Improvement activities

0

Cost

76.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Sung-Un Justin Park M.D., Inc.

  • Neurology Physician
  • Anaheim, CA
  • NPI 1750578761
  Medicare reassignment NPD
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ace Home Health, Inc.

  • Home Health Agency
  • Los Angeles, CA
  • NPI 1205808326
  Care Compare affiliation
• Divine Home Health, Inc.

  • Home Health Agency
  • La Mirada, CA
  • NPI 1831107093
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649298084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 W ORANGE AVE",
            "address_2": "SUITE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-484-8054",
            "fax_number": "714-484-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 W ORANGE AVE",
            "address_2": "SUITE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-484-8054",
            "fax_number": "714-484-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNG-UN",
        "middle_name": "JUSTIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A48704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A487041",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Park
• Robert J. Park, MD
• Sangwon James Park, RPH
• Sarah Park
• Soon Lim Park, ACUPUNCTURIST
• Sungju Park
• Sungmin Park, L.AC.
• Tiffany Park, OD, MS
• Tiffany Park, MD
• Timothy C Park, DDS

• Neurology Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.