DR. SAMUEL JOON PARK M.D.
NPI 1053607952
Internal Medicine in Mineola, NY

Active since June 20, 2011PECOS EnrolledAccepts Medicare Assignment
160 1ST ST UNIT 551, MINEOLA, NY 11501(516) 619-8098 Get Directions Write a Review

NPPES record last updated: November 12, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 12, 2021, Jun 6, 2019, May 29, 2019 and 2 more (5 updates tracked since 2016).

About Dr. Samuel Joon Park M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SAMUEL JOON PARK M.D. (NPI 1053607952) is an individual internal medicine provider in Mineola, New York, licensed in West Virginia (28444) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with St Joseph Regional Medical Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1053607952
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SAMUEL JOON PARKCredential: M.D.
Location Address160 1ST ST UNIT 551Mineola, NY 11501-5025
Mailing Address160 1st St Unit 551Mineola, NY 11501-5025 · (516) 619-8098
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateJune 20, 2011
Last NPPES UpdateNovember 12, 20215 updates tracked since enumeration
NPPES CertifiedNovember 12, 2021
NPI 1053607952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in WV · 28444 Licensed in IN · 01081067A Licensed in CO · CDRH.0057133 Licensed in NY · 285562
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedPediatricsTaxonomy 208000000X · License 285562 (NY), CDRH.0057133 (CO)
160 1ST ST UNIT 551, Mineola, NY 11501

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Samuel Joon Park M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860775475
PECOS Enrollment IDI20260130001137
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
102 services33 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
18 services14 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
13 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph Regional Medical Center

Acute Care Hospitals · Lewiston, ID
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number130003
Location415 Sixth StreetLewiston, ID 83501 · Nez Perce County
Emergency services Birthing friendly

Syringa General Hospital

Critical Access Hospitals · Grangeville, ID
OwnershipGovernment - Hospital District or Authority
CMS Certification Number131315
Location607 W Main StreetGrangeville, ID 83530 · Idaho County
Emergency services

Clearwater Valley Hospital & Clinics

Critical Access Hospitals · Orofino, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131320
Location301 Cedar StreetOrofino, ID 83544 · Clearwater County
Emergency services

St Marys Hospital And Clinics

Critical Access Hospitals · Cottonwood, ID
OwnershipVoluntary non-profit - Private
CMS Certification Number131321
Location701 Lewiston StCottonwood, ID 83522 · Idaho County
Emergency services

Tri-State Memorial Hospital

Critical Access Hospitals · Clarkston, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number501332
Location1221 Highland AvenueClarkston, WA 99403 · Asotin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers30 claims30 services$105.49 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$34.73 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
160 1ST ST UNIT 551
MINEOLA, NY 11501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Park's NPI number?

The NPI number for Samuel Park is 1053607952. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Where is Samuel Park located?

Samuel Park practices at 160 1st St Unit 551, Mineola, NY 11501. The listed phone number is (516) 619-8098.

What is Samuel Park's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Samuel Park enrolled in Medicare?

Yes. Samuel Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Samuel Park affiliated with any hospitals?

According to CMS data, Samuel Park is affiliated with St Joseph Regional Medical Center, Syringa General Hospital, Clearwater Valley Hospital & Clinics, St Marys Hospital And Clinics and Tri-State Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Samuel Park was last updated on November 12, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.