Innjea Park, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N006887 Issued in NY

Practice address

1042 Huguenot Ave
Staten Island, NY 10312-4315

Phone

(917) 796-1693

NPI assigned

Jul 10, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mbip Podiatry PCGroup PAC ID 6901278811, 3 clinicians

Seaview Podiatry P.C.Group PAC ID 9133445018, 4 clinicians

Wyckoff Professional Medical Services PCGroup PAC ID 6406748607, 154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wyckoff Heights Medical Center Hospital, Brooklyn, NY, CCN 330221
• Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: ipark218693@northwell.direct-ci.com
• Direct secure messaging: stmarysfootandanklecenter.innjeapark@148292.advancedmd-direct.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Mbip Podiatry P.C.

  • Foot & Ankle Surgery Podiatrist
  • Staten Island, NY
  • NPI 1992426969
  Medicare reassignment Care Compare group NPD
• Seaview Podiatry P.C.

  • Podiatric Clinic/Center
  • Staten Island, NY
  • NPI 1326446055
  Medicare reassignment Care Compare group NPD
• Wyckoff Professional Medical Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1659710796
  Medicare reassignment Care Compare group NPD
• Fit Feet Podiatry P.C.

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
  • NPI 1588747893
  Medicare reassignment NPD
• Seaview Podiatry P.C.

  • Podiatric Clinic/Center
  • Branchburg, NJ
  • NPI 1679384176

  Foot & Ankle Surgery

  NPD

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

• Staten Island University Hospital

  • General Acute Care Hospital
  • Staten Island, NY
  • NPI 1407877137
  Care Compare affiliation
• Wyckoff Heights Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1700886322
  Care Compare affiliation

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1174907992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124315",
            "telephone_number": "917-796-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 HUGUENOT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124315",
            "telephone_number": "917-796-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "INNJEA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Parisio, NP
• Park Avenue Dermatology
• Park Avenue Dermatology, PC
• Park Slope Comprehensive Medical Wellness PLLC
• Catherine Y Park, MD
• Jane NA Park, DO
• Joann Park, LCSW
• Andrea M. Parker, MA CCC-SLP
• Tracy Parker
• Lauren Elizabeth Parks

• Foot & Ankle Surgery Podiatrist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.