DR. HYOUNGSUP PARK (M.D., PHD) – Family Medicine Physician, NPI 1174512735

DR. HYOUNGSUP PARK (M.D., PHD) is a healthcare provider. based in Springfield, Massachusetts. specializing in Family Medicine Physician. They hold the professional credentials M.D., PHD. They hold a License No. 223132 (MA). The NPI Number for DR. HYOUNGSUP PARK (M.D., PHD) is 1174512735

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. HYOUNGSUP PARK (M.D., PHD)
NPI
1174512735
Phone
(413) 733-4101
Address
305 BICENTENNIAL HWY
Enumeration Date
17 October 2005
Last Update Date
31 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8602844945
Graduation Year
1980 (46 years ago)
PAC ID
2062440266
Group Practice PAC ID
1355246950
Professional Enrollment ID
I20070817000255
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience82
Completeness75
Years active:20State licenses:3Digital endpointsOther names

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Provider Addresses for DR. HYOUNGSUP PARK (M.D., PHD)

  • 305, Bicentennial Highway, Springfield, Hampden County, Massachusetts, 01128, United States

    SPRINGFIELD, MA 011181962

    Phone: (413) 733-4101

    Fax: (413) 796-6821

    Type: Mailing

  • 599 FAMINGTON AVE

    FARMINGTON, CT 06032

    Phone: (608) 284-4945

    Fax: (860) 284-4946

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2007-08-17

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
I20070817000255IFamily PracticeCTTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes194120$0
80053Blood test, comprehensive group of blood chemicals9588$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit9595$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count9488$0
80061Blood test, lipids (cholesterol and triglycerides)8881$0
View full utilization report →

Insurance plans in this area (ZIP 01118)

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Provider's Procedures

DR. HYOUNGSUP PARK (M.D., PHD) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMA90670Pneumococcal vaccine for injection into muscle5151

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: 1355246950View full group profile

Reviews

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Frequently asked questions

What federal number belongs to DR. HYOUNGSUP PARK (M.D., PHD)?
The federal identifier for DR. HYOUNGSUP PARK (M.D., PHD) is NPI 1174512735.
Is DR. HYOUNGSUP PARK (M.D., PHD) currently active in the NPI registry?
CMS-published data lists DR. HYOUNGSUP PARK (M.D., PHD) as an active registrant.
What field does DR. HYOUNGSUP PARK (M.D., PHD) work in?
You can think of DR. HYOUNGSUP PARK (M.D., PHD) as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for DR. HYOUNGSUP PARK (M.D., PHD)?
We surface Springfield, Massachusetts for DR. HYOUNGSUP PARK (M.D., PHD) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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