Jane Park

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F347367 Issued in NY

Practice address

4422 3Rd Ave
Bronx, NY 10457-2545

Phone

(718) 960-9000

Fax

(718) 960-9361

NPI assigned

Aug 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: jpark19277@sbhny.direct-ci.net

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.

• SBH Physicians, PC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1740595917

  Nurse Practitioner

  Medicare reassignment NPD
• SBH Physicians, PC

  • Pediatrics Physician
  • Bronx, NY
  • NPI 1457665937
  NPD

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1174297857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 OUTLOOK AVE APT 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104651184",
            "telephone_number": "718-883-0012",
            "fax_number": "718-960-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 3RD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572545",
            "telephone_number": "718-960-9000",
            "fax_number": "718-960-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F347367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpark3@sbhny.org",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "4422 3rd Ave",
            "city": "Bronx",
            "state": "NY",
            "country_code": "US",
            "postal_code": "104572545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hyun Suk Park
• Hyunyoung Park
• Insook Park
• Inyoung Park
• Jae Hong Park, DMD
• Janet Jeong Park
• Jeasue Josie Park
• Jennifer C Park, RPH
• Jin A Park
• Joo Hee Park, M.D.

• Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.