NPIMap

Individual provider Active NPI

Eun-Jung Park, MD

  • Internal Medicine Physician
  • Monterey, CA
National Provider Identifier
1598866162
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66034 Issued in CA
Practice address
60 Garden CT
Ste 310
Monterey, CA 93940-5370
Phone
(831) 647-3192
Fax
(831) 642-9133
NPI assigned
Sep 26, 2006
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66034 CA Primary

Addresses

Primary practice location

60 Garden CT
Ste 310
Monterey, CA 93940-5370

Mailing address

60 Garden CT
Ste 310
Monterey, CA 93940-5370
Phone (831) 647-3192

Other identifiers 1

IdentifierTypeStateIssuer
00A660340MedicaidCA

Other names 1

  • Eun-Jung Park Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721000947 CA Practitioner - Internal Medicine 9739169756 Reassigns benefits to 1 organization
Practice locations: Monterey, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Columbia University College of Physicians and Surgeons, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Harris CT
Suite B3
Monterey, CA 93940-5739
Phone (831) 647-3192

23625 Holman Hwy
Monterey, CA 93940-5902
Phone (831) 624-5311

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.46 of 100Reported as individual
Quality
21.67
Promoting interoperability
96
Improvement activities
40
Cost
83.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A66034CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 13, 2017 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Jan 13, 2017 Accepting new patients
California Em-I Medical Services Past Accepting new patients
Monterey Bay Heart Center Past Accepting new patients
Salinas Valley Primecare Medical Group Inc Past Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

Organizations & group practices 5

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 5

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1598866162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 GARDEN CT",
            "address_2": "STE 310",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405370",
            "telephone_number": "831-647-3192",
            "fax_number": "831-642-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 GARDEN CT",
            "address_2": "STE 310",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405370",
            "telephone_number": "831-647-3192",
            "fax_number": "831-642-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "EUN-JUNG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A660340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUN-JUNG",
            "last_name": "PARK",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.