Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CHAN SOO PARK MD
NPI 1861485484
Psychiatry & Neurology - Neurology in Poughkeepsie, NY

Q: What is Chan Soo Park's NPI number?

The NPI number for Chan Soo Park is 1861485484. It was assigned to this individual provider in the NPPES registry on August 30, 2005.

Q: What is Chan Soo Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Chan Soo Park was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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.

Active since August 30, 2005PECOS Enrolled

205 SOUTH AVE, SUITE 103, POUGHKEEPSIE, NY 12601(845) 454-2360(845) 454-2361 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Chan Soo Park Md NPPES

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

CHAN SOO PARK MD (NPI 1861485484) is an individual neurology provider in Poughkeepsie, New York, licensed in New York (127160) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861485484

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameCHAN SOO PARKCredential: MD

Location Address205 SOUTH AVE, SUITE 103Poughkeepsie, NY 12601-4818

Mailing Address205 South Ave, Suite 103Poughkeepsie, NY 12601-4818 · (845) 454-2360 · Fax (845) 454-2361

Phone(845) 454-2360

Fax(845) 454-2361

Sole ProprietorNo

Enumeration DateAugust 30, 2005

Last NPPES UpdateJuly 13, 2026

✔ NPI 1861485484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in NY · 127160

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

205 SOUTH AVE, Poughkeepsie, NY 12601

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Other Identifiers 1

Medicaid00503613NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chan Soo Park Md 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 12601 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

$141.77 typical visit price

range $61.88 – $187.05

Typical copayment $35.44 (range $15.47 – $46.76)

Most-billed visit code 99204

Established Patient

$108.56 typical visit price

range $19.92 – $151.94

Typical copayment $27.14 (range $4.98 – $37.98)

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.

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.

MARY DESARIO MSW

Social Worker

205 SOUTH AVE
POUGHKEEPSIE, NY 12601

Dutchess County (845) 554-1365

KARA ANN CANNELLI

Counselor (Mental Health)

205 SOUTH AVE
POUGHKEEPSIE, NY 12601

Dutchess County (845) 485-4680

KRISTIN WOODS

Counselor (Mental Health)

205 SOUTH AVE
POUGHKEEPSIE, NY 12601

Dutchess County (845) 554-1365

MEGAN RAE YORK MHC

Counselor (Mental Health)

205 SOUTH AVE, SUITE 105
POUGHKEEPSIE, NY 12601

Dutchess County (845) 554-1365

DR. JOYCE FRALEIGH DITTENHOEFER AUD

Audiologist

205 SOUTH AVE, SUITE 202
POUGHKEEPSIE, NY 12601

Dutchess County (845) 485-0179

LYNDSEY DUSSLING LMSW

Social Worker

205 SOUTH AVE
POUGHKEEPSIE, NY 12601

Dutchess County (845) 554-1365

MS. WHITNEY ALEXANDRA GARRITT MSW

Social Worker

205 SOUTH AVE
POUGHKEEPSIE, NY 12601

Dutchess County (845) 554-1365

DR. JEFFREY ALAN SAFFIR DC

Chiropractor

205 SOUTH AVE, SUITE 107
POUGHKEEPSIE, NY 12601

Dutchess County (845) 485-5656

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 Chan Soo Park's NPI number?

The NPI number for Chan Soo Park is 1861485484. It was assigned to this individual provider in the NPPES registry on August 30, 2005.

Where is Chan Soo Park located?

Chan Soo Park practices at 205 South Ave Suite 103, Poughkeepsie, NY 12601. The listed phone number is (845) 454-2360.

What is Chan Soo Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Chan Soo Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Chan Soo Park was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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.