NPIMap

Individual provider Active NPI

Andrew John Park, M.D.

  • Urology Physician
  • Mansfield, OH
National Provider Identifier
1730610718
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35.145109 Issued in OH
Practice address
1020 Cricket LN
Mansfield, OH 44906-4104
Phone
(567) 309-2040
Fax
(567) 309-2045
NPI assigned
Mar 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35.145109 OH Primary

Addresses

Primary practice location

1020 Cricket LN
Mansfield, OH 44906-4104

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apark791190@direct.ohiohealth.com Direct OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220512001004 OH Practitioner - Urology 9436403656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Toledo College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

1020 Cricket LN
Mansfield, OH 44906-4104
Phone (567) 309-2040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.145109OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jul 1, 2022 Accepting new patients
Ohiohealth Corporation CurrentSince Jul 1, 2022 Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

1020 Cricket Ln
Mansfield, OH 44906
Phone (419) 526-8443

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1730610718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CRICKET LN",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449064104",
            "telephone_number": "567-309-2040",
            "fax_number": "567-309-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "35.145109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apark791190@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1020 Cricket Ln",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449064104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.