Joonho Park, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

S2867 Issued in TX

Practice address

3571 W Wheatland Rd Ste 101
Dallas, TX 75237-3461

Phone

(972) 274-5555

Fax

(972) 274-5663

NPI assigned

Jun 1, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nephrology

Education

Chicago College of Medicine and Surgery, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dallas Renal Group, P.a.Group PAC ID 0244277283, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Usrc Premier Gaston Dialysis facility, Dallas, TX, CCN 672830
• USRC Premier Richardson Dialysis facility, Richardson, TX, CCN 672740
• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
• Encompass Health Rehabilitation Hospital of Dallas Inpatient rehabilitation facility, Dallas, TX, CCN 673043

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HEHCAD
• Direct secure messaging: jpark@prine.curemd.direct-ci.com

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.

• Dallas Renal Group PA

  • Nephrology Physician
  • Dallas, TX
  • NPI 1629186168
  Medicare reassignment Care Compare group NPD
• Prine Health Medical Group, PLLC

  • Nephrology Physician
  • Manhasset, NY
  • NPI 1144790163
  Medicare reassignment NPD
• Prine Health Medical Group, PLLC

  • Podiatrist
  • Hicksville, NY
  • NPI 1538868336
  NPD
• Transtreme, LLC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1003290453
  NPD (past)

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

• Gadc LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Dallas, TX
  • NPI 1467852186

  Dialysis facility

  Care Compare affiliation Name & address match
• RDC 12 Partners, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Richardson, TX
  • NPI 1366709057

  Dialysis facility

  Care Compare affiliation Name & address match
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation
• Encompass Health Rehabilitation Hospital of Dallas, LLC

  • Rehabilitation Hospital
  • Dallas, TX
  • NPI 1982920773

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1370044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1235576166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CLENT RD APT 2P",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215812",
            "telephone_number": "516-562-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 W WHEATLAND RD STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373461",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOONHO",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-01",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "S2867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Park
• Jason J. Park, MD
• Jason Young Park, MD
• Jeong Ben Park, MD
• Joe Buck Park, R. PH.
• Ki Eun Park, M.D.
• Krystal Blair Park
• Marisol Park, LPC
• Minkyung Park, M.D.
• Nuri Park, NP

• Nephrology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.