Alexander D. Park, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

043733 Issued in GA

Practice address

4255 Johns Creek Pkwy Ste D
Suwanee, GA 30024-6122

Phone

(678) 894-2151

Fax

(678) 894-1745

NPI assigned

Mar 22, 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

Medicare fee-for-service enrollment

Enrolled in GA

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

General Surgery

Education

University of Missouri, Kansas City, School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Park Surgical Specialists LLCGroup PAC ID 8921359977, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexander.park.1@17177.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/17177/brand/1/csg/1/fhir/r4

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.

• Park Surgical Specialists, LLC

  • Specialist
  • Suwanee, GA
  • NPI 1083122055
  Medicare reassignment Care Compare group NPD
• Dekalb Surgical Associates, P.C.

  • Specialist
  • Decatur, GA
  • NPI 1770532590
  NPD (past)

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

• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1710946314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 JOHNS CREEK PKWY STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246122",
            "telephone_number": "678-894-2151",
            "fax_number": "678-894-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 JOHNS CREEK PKWY STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246122",
            "telephone_number": "678-894-2151",
            "fax_number": "678-894-1745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5673 Peachtree Dunwoody Rd NE",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421731",
            "country_code": "US",
            "telephone_number": "404-252-6118",
            "fax_number": "404-252-8016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALEXANDER",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "043733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Landon Pangburn
• Sylvain Panu, LAPC
• Paraclete Counseling Center, Inc
• Kimberly Paris, APRN, FNP-BC
• Park Surgical Specialists, LLC
• Eunse Park, PT, PHD
• Grace Park, MD
• Hayeon Park, NP-C
• Hyeon Hui Park, APRN, FNP-BC
• Julia C Parker, MED, CCC-SLP

• Surgery Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.