Yohan Park, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

236369 Issued in NY

Practice address

4223 212TH St Unit 1a
Bayside, NY 11361-2979

Phone

(718) 229-7337

Fax

(718) 229-7333

NPI assigned

Feb 12, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Bayside Pediatrics PC

  • Pediatrics Physician
  • Bayside, NY
  • NPI 1720565187
  NPD (past) Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1730220666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4223 212TH ST UNIT 1B",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612979",
            "telephone_number": "718-229-7337",
            "fax_number": "718-229-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4223 212TH ST UNIT 1A",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612979",
            "telephone_number": "718-229-7337",
            "fax_number": "718-229-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "236369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02718183",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keun Ae Park, L.AC
• Kwangja Park
• Michelle Park
• Min Joo Park
• SE Joong Park, DPT
• Mery N Parra Saldarriaga
• Dustin Passigli, PT
• Akash Patel
• Seema J Patel, M.D.
• Patient Bridge Health Medical Group, P.a.

• Pediatrics Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.