Stephanie M Park, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704300247 Issued in MI

Practice address

1500 E Medical Center Dr
3Rd Floor Cardiovascular Center Recp C
Ann Arbor, MI 48109-5864

Phone

(888) 287-1082

NPI assigned

Jun 28, 2017

Last updated

Jul 21, 2022By the provider in NPPES

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 HI

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Straub Clinic and HospitalGroup PAC ID 6305759754, 420 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Straub Clinic and Hospital Hospital, Honolulu, HI, CCN 120022

Merit-based Incentive Payment System (MIPS)

Final score

97.05 of 100Reported as apm

Quality

89.81

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Straub Clinic & Hospital

  dba Straub Benioff Medical Center

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1457306508
  Medicare reassignment Care Compare group NPD
• The Queen's Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1487693586
  Medicare reassignment NPD
• Straub Clinic & Hospital

  dba Hawaii Pacific Health Specialty Pharmacy

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1295443216
  NPD
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  NPD

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

• Straub Clinic & Hospital

  dba Straub Benioff Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1720031701
  Care Compare affiliation

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508387812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "3RD FLOOR CARDIOVASCULAR CENTER RECP C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095864",
            "telephone_number": "888-287-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704300247",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704300247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Junyong Park
• Jungje Park, MD
• Marisha Park
• Megan Lesch Park, OTRL
• Pauline Kyonsook Park, MD
• Thomas Park, M.D.
• Yohan Park, DPT
• Dan Parkanzky, RPH
• Susannah Grier Parke, D.O.
• Ebony Chauntae Parker-Featherstone, M.D.

• Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.