Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Samuel Joon Park, MD

Individual provider Internal Medicine Physician · NPI 1053607952

Dr. Samuel Joon Park, MD is an Internal Medicine in Mineola, New York. Qualified in 2011, 15 years ago. Practices with Sound Physicians of Idaho, a 47-clinician group and accepts Medicare assignment. Licensed in Colorado, Indiana, New York and West Virginia.

Years since qualifying
15
Licensed in
CO, IN, NY, WV
In the registry since
2011
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

160 1st St Unit 551
Mineola, NY 11501-5025
Phone: (516) 619-8098
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 28444 (WV)
Internal Medicine Physician Taxonomy 207R00000X · Licence 01081067A (IN)
Pediatrics Physician Taxonomy 208000000X · Licence 285562 (NY)
Pediatrics Physician Taxonomy 208000000X · Licence CDRH.0057133 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence CDRH.0057133 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 285562 (NY)

Record details

NPI number1053607952
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 20, 2011
Last updated in NPPESNovember 12, 2021
Certification dateNovember 12, 2021
Mailing address160 1st St Unit 551, Mineola, NY 11501-5025

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Sound Physicians Of Idaho — 47 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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