Individual provider Active NPI

William Young Park, MD

  • Gastroenterology Physician
  • Washington, DC
National Provider Identifier
1710446026
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0103627 Issued in MD
Practice address
1133 21St St NW Building 2
5TH Floor
Washington, DC 20036-3390
Phone
(202) 416-2000
NPI assigned
Mar 16, 2019
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 280221 MA
Student in an Organized Health Care Education/Training Program 390200000X NU
Gastroenterology Physician 207RG0100X D0103627 MD Primary

Addresses

Primary practice location

1133 21St St NW Building 2
5TH Floor
Washington, DC 20036-3390

Mailing address

593 Eddy St Ste 240
Providence, RI 02903-4923
Phone (401) 444-5034

Other practice location 1

811 Massachusetts Ave
Boston, MA 02118-2605
Phone (617) 445-6400

Other practice location 2

593 Eddy St Ste 240
Providence, RI 02903-4923
Phone (401) 444-5034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250822002348 DC Practitioner - Gastroenterology 2365778628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1133 21St St NW
Medstar at Lafayette Centre
Washington, DC 20036-3390
Phone (202) 416-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2025 Accepting new patients
Boston Medical Center Past Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

1133 21st St NW
Washington, DC 20036
Phone (202) 223-9040

1133 21st St NW
Bldg 2
Washington, DC 20036
Phone (202) 416-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

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 2

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": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1710446026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST STE 240",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 21ST ST NW BUILDING 2",
            "address_2": "5TH FLOOR",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363390",
            "telephone_number": "202-416-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 Massachusetts Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182605",
            "country_code": "US",
            "telephone_number": "617-445-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St Ste 240",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "WILLIAM",
        "middle_name": "YOUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-16",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "280221",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0103627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.