Individual provider Active NPI

Hugo Park, O.D.

  • Optometrist
  • East Rockaway, NY
National Provider Identifier
1891025474
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007082 Issued in NY
Practice address
8 Davison PLZ
East Rockaway, NY 11518-1545
Phone
(347) 717-4117
NPI assigned
Jan 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007082 NY Primary

Addresses

Primary practice location

8 Davison PLZ
East Rockaway, NY 11518-1545

Mailing address

8 Davison PLZ
East Rockaway, NY 11518-1545
Phone (347) 717-4117

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000480 NY Practitioner - Optometry 7810150869 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007082NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Solutions Inc Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Vincente Calderon OD PC Optometrist CurrentSince Apr 26, 2012 Accepting new patients

Locations

2742A E Tremont Ave
Bronx, NY 10461
Phone (347) 422-7380

2742 E Tremont Ave
Bronx, NY 10461
Phone (347) 422-7380

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.

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1891025474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DAVISON PLZ",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181545",
            "telephone_number": "347-717-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DAVISON PLZ",
            "city": "EAST ROCKAWAY",
            "state": "NY",
            "postal_code": "115181545",
            "telephone_number": "347-717-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HUGO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rockaway, NY

Sources for this page

Verify at the official NPI Registry.