Soo-mi Mi Park, MD is a medicare enrolled "Nuclear Medicine - Nuclear Imaging & Therapy" physician in Hackensack, New Jersey. She went to Columbia University College Of Physicians And Surgeons and graduated in 2004 and has 21 years of diverse experience with area of expertise as Cardiovascular Disease (cardiology). She is a member of the group practice Holy Name Hospital Ekg Interpretation Group, Mulkay Cardiology Consultants At Holy Name Medical Center, Pc and her current practice location is
493 Essex Avenue, Hackensack, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(201) 996-9244.
Soo-mi Mi Park is licensed to practice in New Jersey (license number 25MA08918200) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1780700781.
Physician's Profile
Full Name | Soo-mi Mi Park |
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Gender | Female |
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Speciality | Cardiovascular Disease (cardiology) |
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Experience | 21 Years |
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Location | 493 Essex Avenue, Hackensack, New Jersey |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Soo-mi Mi Park attended and graduated from Columbia University College Of Physicians And Surgeons in 2004
NPI Data:
- NPI Number: 1780700781
- Provider Enumeration Date: 03/21/2007
- Last Update Date: 10/15/2013
Medicare PECOS Information:
- PECOS PAC ID: 9830282425
- Enrollment ID: I20110817000613
Medical Identifiers
Medical identifiers for Soo-mi Mi Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780700781 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 237492 (New York) | Secondary |
207UN0902X | Nuclear Medicine - Nuclear Imaging & Therapy | 25MA08918200 (New Jersey) | Primary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 25MA08918200 (New Jersey) | Secondary |
207R00000X | Internal Medicine | 25MA08918200 (New Jersey) | Secondary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Holy Name Hospital Ekg Interpretation Group | 5294798849 | 13 |
Mulkay Cardiology Consultants At Holy Name Medical Center, Pc | 9133355837 | 9 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Soo-mi Mi Park allows following entities to bill medicare on her behalf.
Entity Name | Holy Name Hospital Ekg Interpretation Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1699805978 PECOS PAC ID: 5294798849 Enrollment ID: O20041105000062 |
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Entity Name | Mulkay Cardiology Consultants At Holy Name Medical Center, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366878019 PECOS PAC ID: 9133355837 Enrollment ID: O20131203000750 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Soo-mi Mi Park is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Soo-mi Mi Park, MD 493 Essex Avenue, Hackensack, NJ 07601-1215 Ph: (201) 996-9244 | Soo-mi Mi Park, MD 493 Essex Avenue, Hackensack, NJ 07601-1215 Ph: (201) 996-9244 |
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