Samuel Sanghong Park, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036118586 Issued in IL

Practice address

911 N Elm St Ste 327
Hinsdale, IL 60521-3642

Phone

(630) 387-6589

Fax

(630) 387-9789

NPI assigned

May 8, 2007

Last updated

Oct 12, 2022By the provider in NPPES

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Orthopedic Surgery

Education

New York University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspire Home Healthcare, LLC Home health agency, Morton Grove, IL, CCN 148139
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AJCEBD/Endpoint/AJCEBD

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.

• Specialty Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Hinsdale, IL
  • NPI 1235637851
  Medicare reassignment Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Hazel Crest, IL
  • NPI 1467560128
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate South Suburban Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1558479212
  Care Compare affiliation
• Aspire Home Health Care LLC

  • Home Health Agency
  • Morton Grove, IL
  • NPI 1437392008
  Care Compare affiliation
• Elmhurst Memorial Hospital

  dba Endeavor Health Elmhurst Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1851504377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 327",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 327",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Salt Creek Ln Ste 350",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605218612",
            "country_code": "US",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SAMUEL",
        "middle_name": "SANGHONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036118586",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036118586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@sporthopaedic.com",
            "affiliation": "N",
            "endpointDescription": "Office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "20000 Governors Dr Ste 101",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/fhir/myaurora/api/fhir/dstu2",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "20000 Governors Dr Ste 101",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pandian Medical Corporation LTD (Adroita)
• Shivkumar Pandian, MD
• Aleksandra Papiez Zubek
• Jason Parikh, M.D.
• Mark D Parisi, PSYD
• BJ Parrish, LCSW
• Hannah Paschke, MSW
• Colleen Pasciak, LCSW
• Whitney A Pasquesi, MPH, RDN, LDN
• Ariel Passarelli

• Orthopaedic Surgery Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.