Ji Young Park, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F311044-01 Issued in NY

Practice address

23 Lawrence St
New Hyde Park, NY 11040-1720

Phone

(516) 417-7248

NPI assigned

Jan 20, 2025

Sex

Female

Sole proprietor

Yes

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 NY

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, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Matrix Medical of New York PC

  • Nurse Practitioner
  • New York, NY
  • NPI 1639433063
  Medicare reassignment NPD

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750550400000",
    "number": "1609687508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LAWRENCE ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401720",
            "telephone_number": "516-417-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 LAWRENCE ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401720",
            "telephone_number": "516-417-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JI YOUNG",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "684423",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F311044-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chirag P Parikh
• Priyal Parikh, DPT
• Tattvamasi Parikh, M.D.
• Park One Dental P.C.
• Chang J Park, MD
• John Joon Kyu Park, M.D.
• Joo-Eun Samuel Park, MD
• Kathy Park, RPH, MS
• Kwanyong Park
• Won Park, MD

• Adult Health Nurse Practitioner in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2025; 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.