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

Lisa Kyoun Park, MD

Individual provider Diagnostic Radiology Physician · NPI 1972130938

Lisa Kyoun Park, MD is a Diagnostic Radiology in Madison, Wisconsin. Graduated from Boston University School of Medicine in 2020, 6 years ago. Practices with University of Wisconsin Medical Foundation Inc, a 2,536-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Trained at
Boston University School of Medicine
Licensed in
WI
In the registry since
2020
Specialties on file
2
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

3009 University Ave Apt 602
Madison, WI 53705-3561
Phone: (571) 461-1720
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 75 N Country Rd, Port Jefferson, NY 11777-2190 — (631) 686-2549
  • 600 Highland Ave, Madison, WI 53792-2190 — (608) 263-9729

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 85072 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1972130938
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 26, 2020
Last updated in NPPESJuly 24, 2026
Certification dateJuly 24, 2026

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice University Of Wisconsin Medical Foundation Inc — 2536 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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