Individual provider Active NPI

Richard Young Park, DPM

  • Foot & Ankle Surgery Podiatrist
  • Beachwood, OH
National Provider Identifier
1699352625
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36.004193 Issued in OH
Practice address
23175 Commerce Park Ste C
Beachwood, OH 44122-5806
Phone
(440) 588-8197
NPI assigned
Mar 25, 2021
Last updated
Jun 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 36.004193 OH Primary

Addresses

Primary practice location

23175 Commerce Park Ste C
Beachwood, OH 44122-5806

Mailing address

23175 Commerce Park Ste C
Beachwood, OH 44122-5806
Phone (440) 588-8197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250915001452 OH Practitioner - Podiatry 5294238275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 W Strub Rd
Suite 350
Sandusky, OH 44870-5488
Phone (419) 626-6161

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue104
Removal of nail tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36.004193OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Aug 18, 2025 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Aug 18, 2025 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients

Locations

23175 Commerce Park
Ste C
Beachwood, OH 44122
Phone (440) 588-8197

2500 W Strub Rd
Ste 350
Sandusky, OH 44870
Phone (419) 502-3376

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

Interoperability endpoints

  • Direct secure messaging: rpark29572@nomshealthcare.direct-ci.com
  • Direct secure messaging: rpark38743@ehrdirect.uhhospitals.org

Organizations & group practices 3

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 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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1699352625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23175 COMMERCE PARK STE C",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225806",
            "telephone_number": "440-588-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23175 COMMERCE PARK STE C",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225806",
            "telephone_number": "440-588-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "RICHARD",
        "middle_name": "YOUNG",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.004193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.