LISA KYOUN PARK MD
NPI 1972130938
Radiology - Diagnostic Radiology in Manhasset, NY
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
Specialties & Licenses
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
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.
Medicare Billing Reassignments
4Medicare enrollment records show Lisa Park reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Atkinson, WI 53538
- Reassigned Medicare billing, Wisconsin enrollment
- 298 clinicians in this Medicare group
Madison, WI 53713
- Reassigned Medicare billing, Wisconsin enrollment
- 206 clinicians in this Medicare group
Madison, WI 53717
- Reassigned Medicare billing, Wisconsin enrollment
- 422 clinicians in this Medicare group
Spring Green, WI 53588
- Reassigned Medicare billing, Wisconsin enrollment
- Also billed through NPI 1659301273 (Wisconsin)
- 168 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, WIUniversity Of Wi Hospitals & Clinics Authority
Acute Care Hospitals · Madison, WIPhysician 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.
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.
MANHASSET, NY 11030
MANHASSET, NY 11030
MANHASSET, NY 11030
MANHASSET, NY 11030
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.
Which organizations bill Medicare for Lisa Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Park reassigns Medicare benefits to 4 organizations: Fort Healthcare Inc (Fort Atkinson, WI), University Of Wisconsin System Non Payroll (Madison, WI), Group Health Cooperative Of South Central Wisconsin (Madison, WI) and Richland Hospital (Spring Green, WI). Each 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 Lisa Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 50 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.
# Lisa Kyoun Park, MD · NPI 1972130938
Diagnostic Radiology physician in Manhasset, New York. Individual provider, active in the CMS NPPES registry since March 26, 2020.
## Identity
- **NPI:** 1972130938 (Entity type: Individual)
- **Enumerated:** March 26, 2020
- **Primary specialty:** Radiology - Diagnostic Radiology · taxonomy 2085R0202X
- **State license:** 3975508 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 300 COMMUNITY DR, Manhasset, NY 11030-3816
- **Phone:** (516) 562-0100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Fort Healthcare Inc (NPI 1417450115, Fort Atkinson, WI); University Of Wisconsin System Non Payroll (NPI 1184746828, Madison, WI); Group Health Cooperative Of South Central Wisconsin (NPI 1245260165, Madison, WI); Richland Hospital (NPI 1952094138, Spring Green, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Boston University School Of Medicine, class of 2020
## Record status
- **NPPES last updated:** September 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1972130938) · Data from the CMS NPPES public registry.