DR. SUSIE PARK M.D.
NPI 1114177300
Radiology - Pediatric Radiology in Albany, NY

Active since September 24, 2008PECOS EnrolledAccepts Medicare Assignment
92.56/100
CMS Quality Rating
43 NEW SCOTLAND AVE, DEPT OF RADIOLOGY MC 113, ALBANY, NY 12208(518) 262-3722 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Susie Park M.d. NPPES

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

DR. SUSIE PARK M.D. (NPI 1114177300) is an individual pediatric radiology provider in Albany, New York, licensed in New York (267437) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1114177300
Entity TypeIndividualFemale
Primary Taxonomy2085P0229X
Provider Legal NameDR. SUSIE PARKCredential: M.D.
Location Address43 NEW SCOTLAND AVE, DEPT OF RADIOLOGY MC 113Albany, NY 12208-3412
Mailing Address711 Troy Schenectady Rd, Suite 203Latham, NY 12110-2442 · (518) 782-3700 · Fax (518) 782-3799
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateSeptember 24, 2008
Last NPPES UpdateJanuary 13, 2023
NPI 1114177300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Pediatric RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085P0229X
License Licensed in NY · 267437
Definition

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

43 NEW SCOTLAND AVE, Albany, NY 12208

Other Identifiers 1

Medicaid03649323NY

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. Susie 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 ID3779727284
PECOS Enrollment IDI20150102000008
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.25
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Neonatal, Critical Care)
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE, DEPT. OF EMERGENCY MEDICINE, MAIL CODE: 139
ALBANY, NY 12208
Nurse Anesthetist, Certified Registered
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Specialist/Technologist, Other (Electroneurodiagnostic)
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Student in an Organized Health Care Education/Training Program
43 NEW SCOTLAND AVE
ALBANY, NY 12208
Speech-Language Pathologist
43 NEW SCOTLAND AVE, COMMUNICATION DISORDERS DEPARTMENT MC 128
ALBANY, NY 12208

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 Susie Park's NPI number?

The NPI number for Susie Park is 1114177300. It was assigned to this individual provider in the NPPES registry on September 24, 2008.

Where is Susie Park located?

Susie Park practices at 43 New Scotland Ave Dept Of Radiology Mc 113, Albany, NY 12208. The listed phone number is (518) 262-3722.

What is Susie Park's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Pediatric Radiology, with taxonomy code 2085P0229X.

Is Susie Park enrolled in Medicare?

Yes. Susie 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.

When was this NPI record last updated?

The NPPES record for Susie Park was last updated on January 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.