DR. SAMUEL JOON PARK M.D.
NPI 1053607952
Internal Medicine in Mineola, NY
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
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
8Medicare enrollment records show Samuel Park reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10037
- Reassigned Medicare billing, New York enrollment
- 2,094 clinicians in this Medicare group
Brooklyn, NY 11235
- Reassigned Medicare billing, New York enrollment
- 638 clinicians in this Medicare group
Columbus, OH 43213
- Reassigned Medicare billing, Ohio enrollment
- 776 clinicians in this Medicare group
Chillicothe, OH 45601
- Reassigned Medicare billing, Ohio enrollment
- 204 clinicians in this Medicare group
Bridgeton, MO 63044
- Reassigned Medicare billing, Illinois enrollment
- 419 clinicians in this Medicare group
Humble, TX 77338
- Reassigned Medicare billing, Kansas enrollment
- 245 clinicians in this Medicare group
Greenwood Village, CO 80111
- Reassigned Medicare billing, West Virginia enrollment
- 23 clinicians in this Medicare group
Lewiston, ID 83501
- Reassigned Medicare billing, Idaho enrollment
- 101 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, IDClearwater Valley Hospital & Clinics
Critical Access Hospitals · Orofino, IDOsf Sacred Heart Medical Center
Acute Care Hospitals · Danville, ILAkron General Medical Center
Acute Care Hospitals · Akron, OHTri-State Memorial Hospital
Critical Access Hospitals · Clarkston, WAPhysician 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.
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.
Which organizations bill Medicare for Samuel Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Park reassigns Medicare benefits to 8 organizations: Physician Affiliate Group Of New York PC (New York, NY), Coney Island Medical Practice Plan, P.C. (Brooklyn, NY), Hospitalist Medicine Physicians Of Ohio, Professional Corporation (Columbus, OH), Hospitalist Medicine Physicians Of Ohio-Columbus II Professional Corp (Chillicothe, OH), Sound Physicians Of Illinois, LLC (Bridgeton, MO) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Samuel Park accept?
Health plans from Oscar Insurance Corporation of Ohio list Samuel Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Samuel Park affiliated with any hospitals?
According to CMS data, Samuel Park is affiliated with St Joseph Regional Medical Center, Clearwater Valley Hospital & Clinics, Osf Sacred Heart Medical Center, Akron General Medical Center 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Samuel Joon Park, M.D. · NPI 1053607952
Internal Medicine physician in Mineola, New York. Individual provider, active in the CMS NPPES registry since June 20, 2011.
## Identity
- **NPI:** 1053607952 (Entity type: Individual)
- **Enumerated:** June 20, 2011
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 28444 (West Virginia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 160 1ST ST UNIT 551, Mineola, NY 11501-5025
- **Phone:** (516) 619-8098
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): Physician Affiliate Group Of New York PC (NPI 1013375526, New York, NY); Coney Island Medical Practice Plan, P.C. (NPI 1386951762, Brooklyn, NY); Hospitalist Medicine Physicians Of Ohio, Professional Corporation (NPI 1043572290, Columbus, OH); Hospitalist Medicine Physicians Of Ohio-Columbus II Professional Corp (NPI 1861038069, Chillicothe, OH); Sound Physicians Of Illinois, LLC (NPI 1043598865, Bridgeton, MO); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** November 12, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1053607952) · Data from the CMS NPPES public registry.