Individual provider

Samuel Park, M.D.

Internal Medicine Physician Pediatrics Physician Medicare enrolled

Samuel Park, M.D. is an Internal Medicine Physician in Mineola, NY, registered under NPI 1053607952. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 160 1ST ST UNIT 551, Mineola, NY 11501. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

160 1ST ST UNIT 551, Mineola, NY 11501 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
28444 WV Internal Medicine Physician primary
01081067A IN Internal Medicine Physician
285562 NY Pediatrics Physician
CDRH.0057133 CO Pediatrics Physician
CDRH.0057133 CO Internal Medicine Physician
285562 NY Internal Medicine Physician

Licences are recorded in 4 states: WV, IN, NY, CO. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Internal Medicine
PAC ID
2860775475

Medicare enrolment is recorded as approved under the provider type Practitioner - Internal Medicine. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 4 states

This provider holds licences in 4 states: Colorado, Indiana, New York and West Virginia. The practice address on file is in Mineola, NY, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

CO Colorado
Licence
CDRH.0057133
Specialty
Pediatrics Physician
Verify with the CO board →
IN Indiana
Licence
01081067A
Specialty
Internal Medicine Physician
Verify with the IN board →
NY New York practice address
Licence
285562
Specialty
Pediatrics Physician
Verify with the NY board →
WV West Virginia
Licence
28444
Specialty
Internal Medicine Physician
Verify with the WV board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Internal Medicine covers

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NUCC Health Care Provider Taxonomy, code 207R00000X
Allopathic & Osteopathic Physicians Internal Medicine

All registered taxonomy codes

This provider registers 6 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207R00000X Internal Medicine Physician 28444 WV primary
207R00000X Internal Medicine Physician 01081067A IN
208000000X Pediatrics Physician 285562 NY
208000000X Pediatrics Physician CDRH.0057133 CO
207R00000X Internal Medicine Physician CDRH.0057133 CO
207R00000X Internal Medicine Physician 285562 NY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1053607952 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJun 20, 2011
Last updatedNov 12, 2021
StatusActive
Sole proprietorYes
CredentialM.D.
Practice address 160 1ST ST UNIT 551
Mineola, NY 11501
(516) 619-8098
The last update on file is Nov 12, 2021. Providers are only required to update NPPES when their information changes, so an older date does not necessarily mean the details are wrong — but it is worth a quick call before you travel.

Number check

1053607952 passes the NPI check digit test The final digit 2 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 5 3 6 0 7 9 5
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 1 3 3 0 5 9 1

Sum = 48 · next multiple of 10 = 50 · check digit = 2 · actual last digit = 2

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1053607952?
NPI 1053607952 is the National Provider Identifier assigned to Samuel Park, M.D. in Mineola, NY. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Internal Medicine Physician cover?
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive…
How do I contact Samuel Park, M.D.?
The phone number on file with NPPES is (516) 619-8098, last updated Nov 12, 2021. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Samuel Park, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1053607952 a valid number?
Yes. 1053607952 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.