NPIMap

Individual provider Active NPI

David C Park, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1912107467
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
264918 Issued in NY
Practice address
630 W 168TH St
Department of Pathology and Cell Biology, Columbia Univ
New York, NY 10032-1003
Phone
(212) 639-2000
NPI assigned
Jul 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 231907 MA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 264918 NY Primary

Addresses

Primary practice location

630 W 168TH St
Department of Pathology and Cell Biology, Columbia Univ
New York, NY 10032-1003

Mailing address

630 W 168TH St
Department of Pathology and Cell Biology, Columbia Univ
New York, NY 10032-3725
Phone (212) 639-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120810000031 NY Practitioner - Pathology 8527214311 Reassigns benefits to 3 organizations
I20210722001722 SC Practitioner - PathologyPractitioner - Hematology 8527214311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PathologyAlso: Hematology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231907MAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Anatomic Pathology & Clinical Pathology CurrentSince Sep 10, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 10, 2018 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Aug 9, 2012 Accepting new patients
Memorial Pathology Group Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2012 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jul 15, 2021 Accepting new patients
University Medical Associates of the Medical University of South Carol Anatomic Pathology & Clinical Pathology CurrentSince Jul 15, 2021 Accepting new patients
Memorial Hematology Lymphoma Group CurrentSince Aug 9, 2012 Accepting new patients

Locations

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

630 W 168th St
#23
New York, NY 10032

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1912107467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "DEPARTMENT OF PATHOLOGY AND CELL BIOLOGY, COLUMBIA UNIV",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-639-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "DEPARTMENT OF PATHOLOGY AND CELL BIOLOGY, COLUMBIA UNIV",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321003",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "231907",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "264918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.