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

LISA KYOUN PARK MD
NPI 1972130938
Radiology - Diagnostic Radiology in Manhasset, NY

Active since March 26, 2020PECOS Enrolled
300 COMMUNITY DR, MANHASSET, NY 11030(516) 562-0100 Get Directions Write a Review

NPPES record last updated: September 26, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 26, 2026, Jul 24, 2026, Jul 1, 2025 and 1 more (4 updates tracked since 2020).

About Lisa Kyoun Park Md NPPES

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

LISA KYOUN PARK MD (NPI 1972130938) is an individual diagnostic radiology provider in Manhasset, New York, licensed in New York (3975508) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Boston University School Of Medicine (2020).

NPPES Registry Identity

NPI1972130938
Entity TypeIndividualFemale
Primary Taxonomy2085R0202X
Provider Legal NameLISA KYOUN PARKCredential: MD
Location Address300 COMMUNITY DRManhasset, NY 11030-3816
Mailing Address300 Community DrManhasset, NY 11030-3816
Phone(516) 562-0100
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 2020
Enumeration DateMarch 26, 2020
Last NPPES UpdateSeptember 26, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 26, 2026
✔ NPI 1972130938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in NY · 3975508
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
300 COMMUNITY DR, Manhasset, NY 11030
Open in Google Maps ↗

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

Lisa Kyoun 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 ID9638698020
PECOS Enrollment IDI20250529000930
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.

Hospital Affiliations CMS Care Compare 2

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11030 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
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.

SAMIT SHAH M.D.
Internal Medicine (Advanced Heart Failure and Transplant Cardiology)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-1427
DR. SAMANTHA LING PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8761
DR. DIANA RACHAEL NORDQUIST MD
Anesthesiology
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-8630
DR. STEPHEN JOHN CIPOT IV D.O.
Emergency Medicine
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 684-7598
MR. JOSE LUIS CRUZ PA-C
Physician Assistant
300 COMMUNITY DR, NORTH SHORE UNIVERSITY HOSPITAL
MANHASSET, NY 11030
Nassau County (516) 562-3683
SARAH BETH KORNHABER C.R.N.A.
Nurse Anesthetist, Certified Registered
300 COMMUNITY DR, DEPT OF ANESTHESIA
MANHASSET, NY 11030
Nassau County (516) 562-4887
YUSON CHONG NP
Nurse Practitioner (Acute Care)
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 562-2252
THERESA MARY MOUZAKITIS PA
Physician Assistant
300 COMMUNITY DR
MANHASSET, NY 11030
Nassau County (516) 662-5100

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 Lisa Park's NPI number?

The NPI number for Lisa Park is 1972130938. It was assigned to this individual provider in the NPPES registry on March 26, 2020.

Where is Lisa Park located?

Lisa Park practices at 300 Community Dr, Manhasset, NY 11030. The listed phone number is (516) 562-0100.

What is Lisa Park's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Lisa Park enrolled in Medicare?

Yes. Lisa 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.

Is Lisa Park affiliated with any hospitals?

According to CMS data, Lisa Park is affiliated with Unitypoint Health - Meriter and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Lisa Park was last updated on September 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.