Individual provider Active NPI

Eunbi Park

  • Gerontology Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1588492235
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ15090400 Issued in NJ
Practice address
2 Journal Square PLZ Ste 2
Jersey City, NJ 07306-4001
Phone
(551) 325-2662
NPI assigned
Jul 24, 2024
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ15090400 NJ Primary

Addresses

Primary practice location

2 Journal Square PLZ Ste 2
Jersey City, NJ 07306-4001

Mailing address

2 Journal Square PLZ Ste 2
Jersey City, NJ 07306-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20250228001945 NJ Practitioner - Nurse Practitioner 7012437494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

2 Journal SQ
FL 2
Jersey City, NJ 07306-4006
Phone (201) 963-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Partners of Englewood, PC CurrentSince Apr 6, 2025 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Mar 1, 2025 Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

140 Sylvan Ave
Ste 213
Englewood Cliffs, NJ 07632
Phone (551) 444-2407

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

2 Journal Square Plz
Ste 2
Jersey City, NJ 07306
Phone (201) 963-7000

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.

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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1588492235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JOURNAL SQUARE PLZ STE 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JOURNAL SQUARE PLZ STE 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064001",
            "telephone_number": "551-325-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EUNBI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15090400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.