Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Sae-Lyoung Park, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1609141373

Dr. Sae-Lyoung Park, DPM is a Podiatry in Flushing, New York. Qualified in 2009, 17 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
17
Licensed in
NY
In the registry since
2012
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

143-08 Roosevelt Ave Apt L4
Flushing, NY 11354
Phone: (718) 939-3220
Fax: (718) 939-3440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence N006468 (NY)

Record details

NPI number1609141373
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedMarch 14, 2012
Last updated in NPPESAugust 29, 2023
Certification dateAugust 29, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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