Sungkook Andrew Park, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

17024 Issued in NV

Practice address

8402 Centennial Pkwy
Las Vegas, NV 89149

Phone

(702) 948-8660

NPI assigned

Apr 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Pain ManagementAlso: Anesthesiology

Education

Washington University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: parsa@doclv.emadirect.md

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.

• Desert Orthopaedic Center, LTD.

  • Orthopaedic Surgery Physician
  • Las Vegas, NV
  • NPI 1548235302

  Pain Medicine

  Medicare reassignment Care Compare group NPD
• Centennial Hills Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1487771812
  NPD (past)
• Desert Orthopaedic Billing LLC

  • Orthopaedic Surgery Physician
  • Las Vegas, NV
  • NPI 1972825602
  NPD (past)

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972869345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 CENTENNIAL PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89149",
            "telephone_number": "702-948-8660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89149",
            "country_code": "US",
            "telephone_number": "702-948-8660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8205 W Warm Springs Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133646",
            "country_code": "US",
            "telephone_number": "702-227-2152",
            "fax_number": "702-252-0369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNGKOOK",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NV",
            "license": "17024",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NV",
            "license": "17024",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NV",
            "license": "17024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972869345",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Romy Park, O.D.
• Rustin Jin Park, RN, BSN
• Sarah Park, APRN
• Sehoon Park, MD
• Stewart Dongin Park, M.D.
• Sungyong Park
• Teresa Park
• Young Park
• Conan R Parke, DPM
• Johnny Parke

• Pain Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pain Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.