Amy Y Park, NP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26NJ01069700 Issued in NJ

Practice address

714 31St St
Union City, NJ 07087-2427

Phone

(201) 863-7077

NPI assigned

Nov 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

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.

• North Hudson Community Action Corporation

  • Federally Qualified Health Center (FQHC)
  • Union City, NJ
  • NPI 1548626005
  NPD (past)
• North Hudson Community Action Corporation

  • Federally Qualified Health Center (FQHC)
  • West New York, NJ
  • NPI 1659323442
  NPD (past)

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1205437456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 JACKSON ST APT 840",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070306973",
            "telephone_number": "630-267-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 31ST ST",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872427",
            "telephone_number": "201-863-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "AMY",
        "middle_name": "Y",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ01069700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ APN LICENSE NUMBER",
            "identifier": "26NJ01069700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basilio Pace, DC
• Pain Relief Wellness Center, P.C.
• Panorama Therapy PLLC
• Jorge Agustin Pardo, APN
• Parentini Pharmacy LLC (Parentinis Pharmacy)
• Maria Paschalidis, D.O
• Pasteur Medical Group PA
• Hepal Darshan Patel, DDS
• Megha Patel
• Prachi Patel

• Family Medicine Physician in Union City, NJ
• Providers in Union City, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.