Taehyun Park, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F402603 Issued in NY

Practice address

4115 45TH St Apt 3J
Sunnyside, NY 11104-1922

Phone

(917) 714-8916

NPI assigned

Jun 7, 2019

Sex

Male

Sole proprietor

Yes

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Korean Community Services of Metropolitan New York, Inc.

  • Community/Behavioral Health Agency
  • Flushing, NY
  • NPI 1942687868

  Single Specialty

  Medicare reassignment NPD
• Modern Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1518415983
  Medicare reassignment

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1235798844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 45TH ST APT 3J",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111041922",
            "telephone_number": "917-714-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 45TH ST APT 3J",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111041922",
            "telephone_number": "917-714-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "TAEHYUN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optimal Chiropractic Associates, PLLC
• Rika Ortega, M.S., BCBA
• Our Neighborhood Medical PC
• Timothy Pagel, MS, SLP-CCC
• Diana Pardo
• Satish Patole, D.D.S.
• Anthony John Pavlo, PHD
• Eva Pendleton, LMT
• Andrea Jose Perez
• Physician Healthcare Network,PC

• Psychiatric/Mental Health Nurse Practitioner in Sunnyside, NY
• Providers in Sunnyside, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.