Dr Song Yong Park, DMD in Hogansburg, NY - Medicare Dentist Provider

Dr Song Yong Park, DMD is a medicare enrolled "Dentist" provider in Hogansburg, New York. His current practice location is 412 State Route 37, Hogansburg, New York. You can reach out to his office (for appointments etc.) via phone at (518) 358-3141.

Dr Song Yong Park is licensed to practice in New York (license number 059200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1225486947.

Contact Information

	Dr Song Yong Park, DMD
	412 State Route 37, Hogansburg, NY 13655-3109
	(518) 358-3141
	(518) 358-2797

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Song Yong Park
Gender	Male
Speciality	Dentist
Location	412 State Route 37, Hogansburg, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225486947
Provider Enumeration Date: 06/03/2016
Last Update Date: 05/03/2018

Medicare PECOS Information:

PECOS PAC ID: 9739454117
Enrollment ID: I20171011001498

Medical Identifiers

Medical identifiers for Dr Song Yong Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225486947	NPI	-	NPPES
04880291	Medicaid	NY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	059200 (New York)	Primary

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. Dr Song Yong Park allows following entities to bill medicare on his behalf.

Entity Name	Syracuse Community Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497796353 PECOS PAC ID: 0143121327 Enrollment ID: O20040120000443

Entity Name	St Regis Mohawk Tribe
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457344558 PECOS PAC ID: 5799748547 Enrollment ID: O20041111000764

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. Dr Song Yong 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
Dr Song Yong Park, DMD 412 State Route 37, Hogansburg, NY 13655-3109 Ph: (518) 358-3141	Dr Song Yong Park, DMD 412 State Route 37, Hogansburg, NY 13655-3109 Ph: (518) 358-3141

Reviews and Comments

Dentist in Hogansburg, NY

Dr. Joseph S Park, DDS Dentist Medicare: Medicare Enrolled Practice Location: 412 State Route 37, Hogansburg, NY 13655 Phone: 518-358-3141 Fax: 518-358-2797
Daniel M Cahill, DMD Dentist Medicare: Medicare Enrolled Practice Location: 404 State Route 37, Hogansburg, NY 13655 Phone: 518-358-3141 Fax: 518-358-9175
Mr. Zenas Kuate Defo, DMD Dentist Medicare: Medicare Enrolled Practice Location: St Regis Mohawk Tribe Health Services, 404 State Route 37, Hogansburg, NY 13655 Phone: 518-358-3141 Fax: 518-358-9175
Dr. Michael Thomas Guldan, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 412 State Route 37, Hogansburg, NY 13655 Phone: 518-358-3141 Fax: 518-358-6245
Stefanie Katrina Davis, DDS Dentist Medicare: Medicare Enrolled Practice Location: Saint Regis Mohawk Tribe Health Services, 404 State Route 37, Hogansburg, NY 13655 Phone: 518-358-3141 Fax: 518-358-9175

Dr Song Yong Park, DMD - Medicare Dentist in Hogansburg, NY