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DR. SOO WOONG PARK M.D.
NPI 1205833910
Internal Medicine in Fairfax, VA

Active since July 07, 2005PECOS Enrolled
10680 MAIN ST, STE 130, FAIRFAX, VA 22030(703) 273-6802(703) 273-3960 Get Directions Write a Review

NPPES record last updated: November 13, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Soo Woong Park M.d. NPPES

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

DR. SOO WOONG PARK M.D. (NPI 1205833910) is an individual internal medicine provider in Fairfax, Virginia, licensed in Virginia (0101029694) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205833910
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SOO WOONG PARKCredential: M.D.
Location Address10680 MAIN ST, STE 130Fairfax, VA 22030-3811
Mailing Address10680 Main St, Ste 130Fairfax, VA 22030-3811 · (703) 273-6802 · Fax (703) 273-3960
Phone(703) 273-6802
Fax(703) 273-3960
Sole ProprietorYes
Enumeration DateJuly 7, 2005
Last NPPES UpdateNovember 13, 2009
✔ NPI 1205833910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0101029694
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.
10680 MAIN ST, Fairfax, VA 22030
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Other Names 1

Other Name (5)Dr. Soo W Park M.d.

Other Identifiers 3

Medicare PIN158580
Medicare UPINC88009
Medicaid6075550VA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Soo Woong Park M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22030 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
21 suppliers71 claims141 services$4.62 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers22 claims22 services$1.09 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers16 claims16 services$194.89 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 7

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

AMER Z AL-JUBURI M.D.
Specialist
10680 MAIN ST, SUITE 100
FAIRFAX, VA 22030
Fairfax City (703) 691-4666
AL-JUBURI UROLOGY, PLLC
Specialist
10680 MAIN ST, SUITE 100
FAIRFAX, VA 22030
Fairfax City (703) 691-4666
T & J CHIROPRACTIC INC
Chiropractor
10680 MAIN ST, SUITE 275
FAIRFAX, VA 22030
Fairfax City (703) 539-8822
DR. JAMIE H PARK D.D.S.
Dentist (General Practice)
10680 MAIN ST, SUITE 150
FAIRFAX, VA 22030
Fairfax City (703) 385-4569
DR. JONG HEE CHO D.C.
Chiropractor
10680 MAIN ST, SUITE 275
FAIRFAX, VA 22030
Fairfax City (703) 539-8822
CARE ADVANTAGE INC
Home Health
10680 MAIN ST
FAIRFAX, VA 22030
Fairfax City (703) 436-4767
DR. JAMES PATRICK KACEDAN M.D.
Obstetrics & Gynecology
10680 MAIN ST, SUITE 190
FAIRFAX, VA 22030
Fairfax City (703) 691-1188

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 Soo Woong Park's NPI number?

The NPI number for Soo Woong Park is 1205833910. It was assigned to this individual provider in the NPPES registry on July 7, 2005. The provider is also known as Dr. Soo W Park M.D..

Where is Soo Woong Park located?

Soo Woong Park practices at 10680 Main St Ste 130, Fairfax, VA 22030. The listed phone number is (703) 273-6802.

What is Soo Woong Park's specialty?

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

Is Soo Woong Park enrolled in Medicare?

Yes. Soo Woong Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Soo Woong Park was last updated on November 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.