Bum Y Park, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

168409 Issued in NY

Practice address

4010 70TH St
Woodside, NY 11377-2930

Phone

(718) 899-4600

Fax

(718) 446-8302

NPI assigned

Feb 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 PracticeAlso: Pediatric Medicine

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Networks

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

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1750353124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 70TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772930",
            "telephone_number": "718-899-4600",
            "fax_number": "718-446-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 70TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113772930",
            "telephone_number": "718-899-4600",
            "fax_number": "718-446-8302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21150 45th Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113613357",
            "country_code": "US",
            "telephone_number": "718-229-1188",
            "fax_number": "718-423-3502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "BUM",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "168409",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "168409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01008740",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Pang, PHARMD
• Jennifer Paras, PT, DPT
• Kleomenis D Paraskevas, MD
• Anfernee Cel Calonia Paredes, RPT
• Nived Nishith Parikh
• Jay Eun Park
• Mija Park, NP
• Sung Park, DMD
• Angela Patricia Parra, DPT
• Partners in Aging, LLC

• General Practice Physician in Woodside, NY
• Providers in Woodside, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.