NPIMap

Organization Active NPI

Steve B. Park, MD PC

  • Eyewear Supplier
  • Victor, NY
National Provider Identifier
1750867313
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
STEVE B. PARK, MD PC
Practice address
6534 Anthony Dr Ste B
Victor, NY 14564-1403
Phone
(585) 398-7545
Fax
(585) 398-7578
NPI assigned
Jul 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Authorized official

Name
Dr. Steve Byongkoo Park, MDNPI 1053393009
Title
Owner
Phone
(585) 328-0153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

6534 Anthony Dr Ste B
Victor, NY 14564-1403

Mailing address

2300 Buffalo Rd BLDG 700
Rochester, NY 14624-1367
Phone (585) 328-0153

Other names 1

  • Cornerstone Eye Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181213001575 NY DME Supplier - Physician - OptometristDME Supplier - Optician 0446219372 Practice locations: Victor, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2151160Steve B Park, MD, PC6534 Anthony Drive B, Victor, NY 14564Certificate of waiverJul 12, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Cornerstone Eye Associates6534 Anthony Dr, Victor, NY 14564-1403(585) 398-7545 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jan 1, 1995

National Provider Directory

National Provider Directory
Tax ID family
Elm Ridge Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

160 Sawgrass Dr
Ste 220
Rochester, NY 14620
Phone (585) 244-2200

1972 S Clinton Ave
Rochester, NY 14618
Phone (585) 244-2200

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1750867313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 BUFFALO RD BLDG 700",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241367",
            "telephone_number": "585-328-0153",
            "fax_number": "585-328-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6534 ANTHONY DR STE B",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641403",
            "telephone_number": "585-398-7545",
            "fax_number": "585-398-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE B. PARK, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "BYONGKOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-328-0153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.