Individual provider Active NPI

Jinhee Park, N.P.

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1063772747
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305953 Issued in NY
Practice address
525 East 68TH Street Starr 900
New York, NY 10065-2543
Phone
(212) 746-5562
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305953 NY Primary
Gerontology Nurse Practitioner 363LG0600X F340834 NY

Addresses

Primary practice location

525 East 68TH Street Starr 900
New York, NY 10065-2543

Mailing address

525 East 68TH Street Starr 900
New York, NY 10065-2543
Phone (212) 746-5562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120615000324 NY Practitioner - Nurse Practitioner 7113181538 Reassigns benefits to 1 organization
I20230511003434 NJ Practitioner - Nurse Practitioner 7113181538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

25 Rockwood PL
Suite 120
Englewood, NJ 07631-4958
Phone (201) 568-3335

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F305953NYMDAdult Health Nurse Practitioner
F340834NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Feb 14, 2015 Accepting new patients
Lyons Medical Care, PLLC CurrentSince Nov 4, 2010 Accepting new patients
Weill Medical College of Cornell CurrentSince Feb 14, 2015 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Jun 19, 2023 Accepting new patients
Physician Partners of Englewood, PC Past Accepting new patients
House Calls Medical Group PastSince Nov 1, 2012 Accepting new patients

Locations

25 Rockwood Pl
Ste 200
Englewood, NJ 07631
Phone (201) 608-2848

25 Rockwood Pl
Ste 120
Englewood, NJ 07631
Phone (201) 227-5533

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

30 Montgomery St
Ste 720
Jersey City, NJ 07302
Phone (212) 524-7730

525 E 68th St
#94
New York, NY 10065
Phone (212) 746-5361

156 William St
New York, NY 10038
Phone (646) 962-4679

525 E 68th St
#900
New York, NY 10065
Phone (212) 746-5455

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1063772747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH STREET STARR 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100652543",
            "telephone_number": "212-746-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 EAST 68TH STREET STARR 900",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100652543",
            "telephone_number": "212-746-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JINHEE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305953",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F340834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.