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SANGDO PARK MD
NPI 1164582656
Orthopaedic Surgery - Sports Medicine in Los Angeles, CA

Active since December 12, 2006PECOS EnrolledAccepts Medicare Assignment
2105 BEVERLY BLVD, SUITE 223, LOS ANGELES, CA 90057(213) 989-0644 Get Directions Write a Review

NPPES record last updated: October 24, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Sangdo Park Md NPPES

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

SANGDO PARK MD (NPI 1164582656) is an individual sports medicine provider in Los Angeles, California, licensed in California (A107642) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Columbia University College Of Physicians And Surgeons (2004).

NPPES Registry Identity

NPI1164582656
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameSANGDO PARKCredential: MD
Location Address2105 BEVERLY BLVD, SUITE 223Los Angeles, CA 90057-2216
Mailing Address2105 Beverly Blvd, Suite 223Los Angeles, CA 90057-2216 · (213) 989-0644
Phone(213) 989-0644
Sole ProprietorYes
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 2004
Enumeration DateDecember 12, 2006
Last NPPES UpdateOctober 24, 2012
✔ NPI 1164582656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
Licenses✔ Licensed in CA · A107642✔ Licensed in TX · N6562
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
2105 BEVERLY BLVD, Los Angeles, CA 90057
Open in Google Maps ↗

Other Identifiers 5

Other8CR159TX · Bc/bs Tx - Effect. 02/01/2011
Medicare NSC6484850003TX
Other8W9051TX · Bcbs
OtherP00935331TX · Railroad Medicare
Medicare PINTXB126770TX

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

Sangdo Park Md 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 ID4082897004
PECOS Enrollment IDI20121015000393
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 Billing Reassignment

Medicare enrollment records show Sangdo Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sangdo Park, M.D., A Professional Corporation
Same address
Sports Medicine
2105 BEVERLY BLVD, SUITE 223
Los Angeles, CA 90057
  • Reassigned Medicare billing, California enrollment
NPI 1346590098 (213) 989-0644

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 6

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.

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
276 services82 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
205 services108 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
83 services70 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
82 services69 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
71 services71 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
50 services50 patients

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.

Reported Quality Measures

Total Knee Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy
Percentage of patients regardless of age undergoing a total knee replacement with documented shared decision-making with discussion of conservative (non-surgical) therapy (e.g. nonsteroidal anti-inflammatory drug (NSAIDs), analgesics, weight loss, exercise…
100%38 patients
Total Knee Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation
Percentage of patients regardless of age undergoing a total knee replacement who are evaluated for the presence or absence of venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g. history of Deep Vein Thrombosis…
100%38 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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. GEORGE U SUYAT MD, MPH
Internal Medicine
2105 BEVERLY BLVD, SUITE 131
LOS ANGELES, CA 90057
Los Angeles County (213) 413-8836
ABDUL RAB KHAN MD
General Practice
2105 BEVERLY BLVD, SUITE 231
LOS ANGELES, CA 90057
Los Angeles County (213) 483-8400
BEVERLY MULTISPECIALTY CLINIC INC
Internal Medicine
2105 BEVERLY BLVD, STE 111
LOS ANGELES, CA 90057
Los Angeles County (213) 484-3994
ORBIT CARE INC
Internal Medicine
2105 BEVERLY BLVD, STE 231
LOS ANGELES, CA 90057
Los Angeles County (213) 399-5382
STAT HOME HEALTH CARE, INC.
Home Health
2105 BEVERLY BLVD, STE. 221
LOS ANGELES, CA 90057
Los Angeles County (213) 483-2355
ANNABELLA B CHU DMD INC
Dentist (General Practice)
2105 BEVERLY BLVD, STE. 215
LOS ANGELES, CA 90057
Los Angeles County (213) 413-4444
MEDHAT MANSOUR M.D.
Urology
2105 BEVERLY BLVD, SUITE 207
LOS ANGELES, CA 90057
Los Angeles County (213) 483-1007
JAY J. CHOBDEE, DDS A PROFESSIONAL CORPORATION
Dentist
2105 BEVERLY BLVD, #101
LOS ANGELES, CA 90057
Los Angeles County (213) 484-1288

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 Sangdo Park's NPI number?

The NPI number for Sangdo Park is 1164582656. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is Sangdo Park located?

Sangdo Park practices at 2105 Beverly Blvd Suite 223, Los Angeles, CA 90057. The listed phone number is (213) 989-0644.

What is Sangdo Park's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Sangdo Park enrolled in Medicare?

Yes. Sangdo 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 organization bills Medicare for Sangdo Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sangdo Park reassigns Medicare benefits to Sangdo Park, M.D., A Professional Corporation (Los Angeles, CA). The 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 Sangdo Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sangdo Park was last updated on October 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.