Youngkun Park, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA156932 Issued in OR

Practice address

5100 S Macadam Ave Ste 200
Portland, OR 97239-3827

Phone

(971) 202-5500

Fax

(971) 202-5555

NPI assigned

Apr 1, 2010

Sex

Female

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 OR

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

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Housecall Providers PCGroup PAC ID 7113297789, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: youngkunpark@hpi.allscriptsdirect.net

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.

• Housecall Providers, PC

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1396274817
  Medicare reassignment Care Compare group
• Housecall Providers Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, OR
  • NPI 1619915774
  NPD
• Housecall Providers Services, LLC

  • Community Based Hospice Care Agency
  • Portland, OR
  • NPI 1174051668
  NPD (past)

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1265757322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 S MACADAM AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393827",
            "telephone_number": "971-202-5500",
            "fax_number": "971-202-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOUNGKUN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA156932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Alex Park
• Penny Park
• Richard I. Park, DMD
• Seo Young Park
• Taylor Park
• Bradley Reed Parke, MD
• Brede Edgar Martin Parker-Adams, PSYD
• Lillian Parker-Halstead
• Angela Jodee-Grace Parker, MOTR/L
• April Parker, CADC II

• Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.