Soon John Park, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

294105 Issued in NY

Practice address

319 S Manning Blvd Ste 110a
Albany, NY 12208-1743

Phone

(518) 525-2525

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Thoracic Surgery

Education

University of Chicago, Pritzker School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Albany Medical CollegeGroup PAC ID 1759293111, 1,054 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688

  Surgery

  Medicare reassignment Care Compare group NPD
• Ellis Hospital

  • General Acute Care Hospital
  • Schenectady, NY
  • NPI 1487644993
  Medicare reassignment NPD
• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834
  Medicare reassignment NPD
• University Surgical Associates, LLP

  • Surgery Physician
  • Syracuse, NY
  • NPI 1376590117
  Medicare reassignment NPD
• Western New York Medical Practice P.C.

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1063790608

  Surgery

  Medicare reassignment NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517

  Surgery

  NPD
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  NPD (past)
• St. Peter'S Health Partners Medical Associates, P.C.

  • Pediatrics Physician
  • Slingerlands, NY
  • NPI 1669717260
  NPD (past)
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  NPD (past)

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

• Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Niskayana, NY
  • NPI 1154973071

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  Care Compare affiliation
• Albany Medical Center Hospital

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1700204641

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • Radiology Clinic/Center
  • Albany, NY
  • NPI 1811448657

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1891716544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S MANNING BLVD STE 110A",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081743",
            "telephone_number": "518-525-2525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7255 Old Oak Blvd Ste B-311",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441303329",
            "country_code": "US",
            "telephone_number": "440-816-2638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1735 Route 9",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120652421",
            "country_code": "US",
            "telephone_number": "518-525-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOON",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "294105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609723500",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spark@swdirect.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group, Inc.",
            "address_1": "7255 Old Oak Blvd Ste B-311",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441303329",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "319 S Manning Blvd Ste 110A",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Park
• Hye Yang Park, DDS
• Isadora Park, PA-C
• John Juwon Park, DMD
• Kristine Park, M.D.
• Susie Park, M.D.
• Leigh Ann Parker, DPT
• Sally Parker
• Shana Rae Parkins, CRNA
• James R Parkinson, M.D.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Albany, NY
• Providers in Albany, NY by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.