Individual provider Active NPI

Jung Eun Park, MD

  • Anesthesiology Physician
  • Bronx, NY
National Provider Identifier
1245551894
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
275290 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 466-8153
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 275290 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

68 S Service Rd Ste 350
Melville, NY 11747-2358
Phone (703) 295-9360

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807000552 NY Practitioner - Anesthesiology 6406073949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia LLPGroup PAC ID 7719885771, 427 clinicians

Practice addresses (Care Compare)

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Resource Anesthesiology Associates,PC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Yorkville Endoscopy, LLC CurrentSince Aug 25, 2023 Accepting new patients
Lynbrook Anesthesia Services, PC Anesthesiology CurrentSince May 1, 2021 Accepting new patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Aug 1, 2014 Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

88 Ashford Ave
Dobbs Ferry, NY 10522
Phone (914) 591-8400

220 N Belle Mead Rd
East Setauket, NY 11733
Phone (516) 681-8400

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

4604 31st Ave
Long Island City, NY 11103
Phone (718) 545-2100

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

355 W 52nd St
New York, NY 10019
Phone (646) 754-2100

201 E 93rd St
New York, NY 10128
Phone (917) 281-0100

320 Montauk Hwy
West Islip, NY 11795
Phone (360) 514-9060

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1245551894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD STE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472358",
            "telephone_number": "703-295-9360",
            "fax_number": "516-945-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-466-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG EUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "275290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.