SANGTAE PARK (MD) – Urology Physician, NPI 1356300487

SANGTAE PARK (MD) is a healthcare provider. based in Skokie, Illinois. specializing in UROLOGY. They hold the professional credentials MD. They hold a License No. M0855 (TX). The NPI Number for SANGTAE PARK (MD) is 1356300487

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
SANGTAE PARK (MD)
NPI
1356300487
Phone
(847) 676-2400
Address
9711 SKOKIE BLVD
Enumeration Date
18 March 2006
Last Update Date
20 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
6800831603
Group Practice PAC ID
2163334699
Professional Enrollment ID
I20071221000141
Address ID
IL602011700EV2650XAVEX300
Telehealth
Yes

Contacts

Secure Messaging
spark218691@direct.northshore.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness95
Years active:20State licenses:2Other names

543 UROLOGY in IL

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Provider Addresses for SANGTAE PARK (MD)

  • 9711, Skokie Boulevard, Skokie, Niles Township, Cook County, Illinois, 60077, United States

    STE H

    SKOKIE, IL 600771384

    Phone: (847) 676-2400

    Fax: (847) 676-2485

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 14 Open Payments records for all available years, with a total value of $965.

Total Amount is formed as General ($965) + Research ($0) + Ownership ($0) = $965.

Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($820).

Total Amount

$965

General + Research + Ownership

Payments

14

Total payment records

General Amount

$965

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-12-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071221000141IUrologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes342321$0
99214Established patient office or other outpatient visit, 30-39 minutes265247$0
52000Diagnostic exam of bladder and urethra using an endoscope11486$0
99204New patient office or other outpatient visit, 45-59 minutes106106$0
99203New patient office or other outpatient visit, 30-44 minutes8989$0
View full utilization report →

Insurance plans in this area (ZIP 60077)

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Provider's Procedures

SANGTAE PARK (MD) performs procedures in UROLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
UROLOGYIL55700Biopsy of prostate gland2020
UROLOGYIL76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle2220

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163334699View full group profile
NameSpecialtyState
-IL
E N D O C R I N O L O G YIL
N E U R O L O G YIL
Hospitalist, Internal MedicineIL
O P H T H A L M O L O G YIL
-IL
E N D O C R I N O L O G YIL
Cardiovascular Disease (Cardiology), Interventional CardiologyIL
Clinical Social WorkerIL
Certified Nurse Midwife (Cnm)IL

Reviews

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Frequently asked questions

Is SANGTAE PARK (MD) listed with a National Provider Identifier?
Yes — SANGTAE PARK (MD) has NPI 1356300487 on file in the registry.
Is there an active status for SANGTAE PARK (MD)?
For scheduling context, SANGTAE PARK (MD) is shown as active in the registry.
What clinical focus is listed for SANGTAE PARK (MD)?
At a glance, SANGTAE PARK (MD) is tied to Urology Physician. Clinical services aligned with this taxonomy classification.
Is SANGTAE PARK (MD) located near Skokie?
SANGTAE PARK (MD) currently maps to Skokie, Illinois in this extract.
Does SANGTAE PARK (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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