Active NPI
Helen Jisoo Park, O.D.
- Optometrist
- Annandale, NJ
National Provider Identifier
1497856124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00616900
- Practice address
- 1465 State Route 31 S
Annandale, NJ 08801-3129 - Phone
- (908) 730-6774
- NPI assigned
- Sep 26, 2006
- Last updated
- Apr 19, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT 13015 T | CA | |
| Optometrist | 152W00000X | 27OA00616900 | NJ | Primary |
Addresses
Primary practice location
1465 State Route 31 S
Annandale, NJ 08801-3129
Mailing address
1465 State Route 31 S
Annandale, NJ 08801-3129
Phone (908) 730-6774
Other names 1
- Jisoo Park
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT 13015 T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milauskas Eye Institute Medical Group II Inc | Optometrist | Past | Accepting new patients |
| Milauskas Eye Institute Medical Group II Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Milauskas Eye Institute
- Ophthalmology Physician
- Rancho Mirage, CA
- NPI 1235210584
Optometrist
-
dba Milauskas Eye Institute
- Ophthalmology Physician
- La Quinta, CA
- NPI 1295803153
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240099200000",
"number": "1497856124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 STATE ROUTE 31 S",
"city": "ANNANDALE",
"state": "NJ",
"postal_code": "088013129",
"telephone_number": "908-730-6774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 STATE ROUTE 31 S",
"city": "ANNANDALE",
"state": "NJ",
"postal_code": "088013129",
"telephone_number": "908-730-6774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "HELEN",
"middle_name": "JISOO",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2009-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "OPT 13015 T",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NJ",
"license": "27OA00616900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JISOO",
"last_name": "PARK",
"credential": "O.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Annandale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.