Dr Susie Park, MD - Medicare Radiology in Albany, NY

Dr Susie Park, MD is a medicare enrolled "Radiology - Pediatric Radiology" physician in Albany, New York. Her current practice location is 43 New Scotland Ave, Dept Of Radiology Mc 113, Albany, New York. You can reach out to her office (for appointments etc.) via phone at (518) 262-3722.

Dr Susie Park is licensed to practice in New York (license number 267437) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114177300.

Contact Information

Dr Susie Park, MD
43 New Scotland Ave, Dept Of Radiology Mc 113,
Albany, NY 12208-3412
(518) 262-3722
Not Available



Physician's Profile

Full NameDr Susie Park
GenderFemale
SpecialityRadiology - Pediatric Radiology
Location43 New Scotland Ave, Albany, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114177300
  • Provider Enumeration Date: 09/24/2008
  • Last Update Date: 01/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3779727284
  • Enrollment ID: I20150102000008

Medical Identifiers

Medical identifiers for Dr Susie Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114177300NPI-NPPES
03649323MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085P0229XRadiology - Pediatric Radiology 267437 (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 Susie Park allows following entities to bill medicare on her behalf.
Entity NameSouthern California Permanente Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678

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Entity NameLos Alamitos Radiology Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427005024
PECOS PAC ID: 5092718882
Enrollment ID: O20060816000607

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Entity NameGlendora Radiological Assoc Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992797070
PECOS PAC ID: 2163514589
Enrollment ID: O20070815000331

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Entity NameGolden State Imaging Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144872052
PECOS PAC ID: 1254761315
Enrollment ID: O20200414001788

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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. Dr Susie 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 AddressPractice Location Address
Dr Susie Park, MD
711 Troy Schenectady Rd, Suite 203,
Latham, NY 12110-2442

Ph: (518) 782-3700
Dr Susie Park, MD
43 New Scotland Ave, Dept Of Radiology Mc 113,
Albany, NY 12208-3412

Ph: (518) 262-3722

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Radiology Doctors in Albany, NY

Robert A Belgam, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 113 Holland Ave, Stratton Va Medical Center, Albany, NY 12208
Phone: 518-626-6650    Fax: 518-626-6644
Mr. Sreenivas Garla, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 47 New Scotland Ave, Radiology Dept, Albany, NY 12208
Phone: 518-262-3277    Fax: 518-262-4210
David Jahangir, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 315 S Manning Blvd, Albany, NY 12208
Phone: 518-525-1401    
Dr. S Rao Aravapalli, MD
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 47 New Scotland Ave, Dept. Of Radiology, Albany, NY 12208
Phone: 518-262-3277    Fax: 518-262-4210
Sean Peter Roddy, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 391 Myrtle Ave., Suite 5, The Vascular Group, Pllc, Albany, NY 12208
Phone: 518-262-5640    Fax: 518-262-9413
Dena Miller, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 315 S Manning Blvd, Albany, NY 12208
Phone: 518-525-1401    
Matthew Robert Shalvoy, MD
Radiology
Medicare: Medicare Enrolled
Practice Location: 315 S Manning Blvd, Albany, NY 12208
Phone: 518-525-1401    Fax: 518-525-1200

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