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DR. SAMUEL S PARK M.D.
NPI 1124551239
Anesthesiology in Kirkland, WA

Active since April 05, 2017PECOS EnrolledAccepts Medicare Assignment
12040 NE 128TH ST, KIRKLAND, WA 98034(425) 899-3455 Get Directions Write a Review

NPPES record last updated: September 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Samuel S Park M.d. NPPES

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

DR. SAMUEL S PARK M.D. (NPI 1124551239) is an individual anesthesiology provider in Kirkland, Washington, licensed in Washington (MD61147982) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Evergreenhealth Monroe, and is a graduate of University Of Washington School Of Medicine (2017).

NPPES Registry Identity

NPI1124551239
Entity TypeIndividualMale
Primary Taxonomy207L00000X
Provider Legal NameDR. SAMUEL S PARKCredential: M.D.
Location Address12040 NE 128TH STKirkland, WA 98034-3013
Mailing AddressPo Box 4069Everett, WA 98204-0007 · (206) 543-2470
Phone(425) 899-3455
Sole ProprietorNo
Medical School CMSUniversity Of Washington School Of MedicineGraduated 2017
Enumeration DateApril 5, 2017
Last NPPES UpdateSeptember 30, 2021
NPPES CertifiedSeptember 30, 2021
✔ NPI 1124551239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in WA · MD61147982
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
12040 NE 128TH ST, Kirkland, WA 98034
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

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 S 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 ID8729356985
PECOS Enrollment IDI20210430000406
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

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.

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731
This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Evergreenhealth Monroe

Acute Care Hospitals · Monroe, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500084
Location14701 179th Ave SEMonroe, WA 98272 · Snohomish County
Emergency services

Evergreenhealth Medical Center

Acute Care Hospitals · Kirkland, WA
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500124
Location12040 NE 128th StreetKirkland, WA 98034 · King County
Emergency services Birthing friendly

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.

DR. SHILPA KORAH PHARMD
Pharmacist
12040 NE 128TH ST, TAN 415/ MS31
KIRKLAND, WA 98034
King County (425) 899-2783
DARLENE ELAINE GRINDE RN
Registered Nurse
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 218-6241
AUSTIN M GROSS M.D.
Emergency Medicine
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-1711
JUNE L. LEE MD
Anesthesiology
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-1000
ERIN-SIOBHAIN ROSS CURRIN M.D.
Internal Medicine (Hematology & Oncology)
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-3181
RACHANA GUDIPUDI
Anesthesiology
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 400-7908
FONG KIT TAM PHARMD
Pharmacist
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-2761
KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2
General Acute Care Hospital
12040 NE 128TH ST
KIRKLAND, WA 98034
King County (425) 899-1000

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 1124551239. It was assigned to this individual provider in the NPPES registry on April 5, 2017.

Where is Samuel Park located?

Samuel Park practices at 12040 NE 128th St, Kirkland, WA 98034. The listed phone number is (425) 899-3455.

What is Samuel Park's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

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.

What insurance does Samuel Park accept?

Health plans from Premera Blue Cross Blue Shield of Alaska 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 Evergreenhealth Monroe and Evergreenhealth Medical Center.

When was this NPI record last updated?

The NPPES record for Samuel Park was last updated on September 30, 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.