Individual provider Active NPI

Jocelyn A Park, M.D.

  • Anesthesiology Physician
  • Springfield, OR
National Provider Identifier
1609960228
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD29176 Issued in OR
Practice address
3333 Riverbend Drive
Springfield, OR 97477-8800
Phone
(541) 222-3154
Fax
(541) 222-3359
NPI assigned
Oct 3, 2006
Last updated
Oct 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 1314 NH
Anesthesiology Physician 207L00000X MD29176 OR Primary

Addresses

Primary practice location

3333 Riverbend Drive
Springfield, OR 97477-8800

Mailing address

P.O. Box 7247
Springfield, OR 97475-0011
Phone (541) 686-9551

Other identifiers 1

IdentifierTypeStateIssuer
1314OtherNHRESIDENTS LICENCE

Other names 1

  • Jocelyn A Elliotl Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090708000167 OR Practitioner - Anesthesiology 3173674934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of New Mexico School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKenzie Physician Services LLCGroup PAC ID 1254307994, 48 clinicians
Northwest Anesthesia Physicians PCGroup PAC ID 3274420138, 93 clinicians

Practice addresses (Care Compare)

1460 G St
Springfield, OR 97477-4112
Phone (541) 744-8613

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-2300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
75.94
Promoting interoperability
100
Improvement activities
40
Cost
83.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD29176ORMDAnesthesiology Physician
1314NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Physician Services LLC CurrentSince Sep 16, 2022 Accepting new patients
Northwest Anesthesia Physicians PC Anesthesiology CurrentSince Jul 13, 2009 Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

3333 Riverbend Dr
Springfield, OR 97477
Phone (541) 222-3154

3355 Riverbend Dr
Ste 240
Springfield, OR 97477
Phone (541) 687-1712

Interoperability endpoints

  • Direct secure messaging: parkj062@yourcarecommunity.org

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 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1609960228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 7247",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750011",
            "telephone_number": "541-686-9551",
            "fax_number": "541-687-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RIVERBEND DRIVE",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-3154",
            "fax_number": "541-222-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOCELYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "1314",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD29176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENTS LICENCE",
            "identifier": "1314",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOCELYN",
            "last_name": "ELLIOTL",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.