Individual provider Active NPI

Sung Jin Park, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Hershey, PA
National Provider Identifier
1760449839
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD074218L Issued in PA
Practice address
500 University Dr
MC A410
Hershey, PA 17033-2360
Phone
(800) 243-1455
NPI assigned
May 1, 2006
Last updated
Sep 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD074218L PA Primary

Addresses

Primary practice location

500 University Dr
MC A410
Hershey, PA 17033-2360

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other practice location 1

503 N 21st St
Camp Hill, PA 17011-2204
Phone (800) 243-1455

Other practice location 2

875 Poplar Church Rd
Suite 400
Camp Hill, PA 17011-2203
Phone (717) 975-0900

Other practice location 3

252 S 4th St Fl 2
Lebanon, PA 17042-6111
Phone (717) 270-3751

Other identifiers 1

IdentifierTypeStateIssuer
0018584840007MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spark122084@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040614000851 PA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 5294719779 Reassigns benefits to 2 organizations
I20250312001807 NY Practitioner - Thoracic Surgery 5294719779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Virginia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians

Practice addresses (Care Compare)

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD074218LPAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Oct 10, 2024 Accepting new patients
Ellis Hospital CurrentSince Feb 24, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Wellspan Medical Group CurrentSince Oct 10, 2024 Accepting new patients
Spirit Physician Services Past Accepting new patients
Capital Area Cardiovascular Surgical Institute Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

1201 Nott St
Ste 307
Schenectady, NY 12308
Phone (518) 243-3388

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

252 S 4th St
Fl 2
Lebanon, PA 17042
Phone (717) 270-3751

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: spark122084@direct.geisinger.edu

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1760449839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "800-243-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "503 N 21st St",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170112204",
            "country_code": "US",
            "telephone_number": "800-243-1455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Poplar Church Rd",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Camp Hill",
            "state": "PA",
            "postal_code": "170112203",
            "country_code": "US",
            "telephone_number": "717-975-0900",
            "fax_number": "717-975-2724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "252 S 4th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-3751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNG",
        "middle_name": "JIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD074218L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018584840007",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spark122084@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 University Dr",
            "address_2": "MC A410",
            "city": "Hershey",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170332360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.