DR. SUSIE PARK M.D.
NPI 1114177300
Radiology - Pediatric Radiology in Albany, NY

NPI Status: Active since September 24, 2008

Contact Information

43 NEW SCOTLAND AVE
DEPT OF RADIOLOGY MC 113
ALBANY, NY
ZIP 12208
Phone: (518) 262-3722

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  • Individual
  • Female
  • Years of Experience 19
  • Radiology
  • Pediatric Radiology
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SUSIE PARK

This page provides the complete NPI Profile along with additional information for Susie Park, a provider established in Albany, New York with a medical specialization in Radiology, focusing in pediatric radiology and more than 19 years of experience. The healthcare provider is registered in the NPI registry with number 1114177300 assigned on September 2008. The practitioner's primary taxonomy code is 2085P0229X with license number 267437 (NY). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1114177300
Provider Name
DR. SUSIE PARK M.D.
Gender
Female
Entity Type
Individual
Location Address
43 NEW SCOTLAND AVE DEPT OF RADIOLOGY MC 113 ALBANY, NY 12208
Location Phone
(518) 262-3722
Mailing Address
711 TROY SCHENECTADY RD SUITE 203 LATHAM, NY 12110
Mailing Phone
(518) 782-3700
Mailing Fax
Medical School Name
OTHER
Graduation Year
2007
Is Sole Proprietor?
No
Enumeration Date
09-24-2008
Last Update Date
01-13-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Pediatric Radiology

Taxonomy Code
2085P0229X
Type
Allopathic & Osteopathic Physicians
License No.
267437
License State
NY
Taxonomy Description
A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
03649323MEDICAID (05)NY 

Medicare Participation & PECOS Enrollment Status

Susie Park is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Susie Park is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3779727284

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20150102000008

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for DR. SUSIE PARK M.D.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1114177300
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2124271430
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 2 + 7 + 1 + 4 + 3 + 0 + 24 = 50
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1114177300 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1124022181DR. FLORENCE ELIZABETH THARMAN AU.D
Individual
Audiologist-Hearing Aid Fitter43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4918
1821099540DR. FRANK J THOMAS MD
Individual
Radiology (Radiation Oncology)43 NEW SCOTLAND AVE DEPT RADIATION ONCOLOGY
ALBANY, NY 12208
(518) 262-3368
1750377586 MARIA DIAZ PARKER P.A.
Individual
Physician Assistant43 NEW SCOTLAND AVE MAIL CODE 7
ALBANY, NY 12208
(518) 262-6696
1023005527 EDWIN TAFT M.D.
Individual
Internal Medicine (Hematology)43 NEW SCOTLAND AVE MAIL CODE 7
ALBANY, NY 12208
(518) 262-6696
1013906106 JULIE ANNE KERWOOD MS
Individual
Audiologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4535
1851381693 KITTY JOY THOMAS NP
Individual
Nurse Practitioner43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-1006
1245220045 REBECCA GUERRETTE ROSEN SLP
Individual
Speech-Language Pathologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4526
1801886981 STACY M VANDERHORST MS
Individual
Speech-Language Pathologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4526
1669449138 WILLIAM R MCCLELLAN RPA C
Individual
Physician Assistant43 NEW SCOTLAND AVE MC157 THE VASCULAR GROUP PLLC
ALBANY, NY 12208
(518) 262-5640
1205804408MR. RICK L. MCLAUGHLIN PA-C
Individual
Physician Assistant (Surgical)43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-3494
1992774368 STEPHANIE LYNN DONATO MS
Individual
Speech-Language Pathologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4526
1053380477 CHRISTOPHER WARREN DOTI NP
Individual
Nurse Practitioner (Family)43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-5149
1477522720 JACQUELINE MARIE KLEIN MA
Individual
Speech-Language Pathologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4526
1790745727DR. TOBIE ANN DORN PHD
Individual
Psychologist43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4526
1679595151 JOSEF F LANGE PA
Individual
Physician Assistant43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-3472
1912921289 GLEN P RAMOS RPAC
Individual
Physician Assistant43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4919
1861506750 CATHY S BELAND M.D.
Individual
Emergency Medicine43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-4050
1972692887MR. JUSTIN POTTER PENDERGRAST PA-C
Individual
Physician Assistant43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-6575
1154481695MS. JOANNE GALAYDA NP
Individual
General Acute Care Hospital43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-3125
1558411108MRS. RUTH IDA SIMMONS CNM
Individual
Advanced Practice Midwife43 NEW SCOTLAND AVE
ALBANY, NY 12208
(518) 262-8234

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114177300, enumerated in the NPI registry as an "individual" on September 24, 2008

The provider is located at 43 New Scotland Ave Dept Of Radiology Mc 113 Albany, Ny 12208 and the phone number is (518) 262-3722

The provider's speciality is Radiology with taxonomy code 2085P0229X with a focus in Pediatric Radiology

The provider has more than 19 years of experience.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

This NPI record was last updated on September 24, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.