Min Park, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024195870 Issued in VA

Practice address

11240 Waples Mill Rd Ste 300
Fairfax, VA 22030-6078

Phone

(571) 407-5042

NPI assigned

Jan 26, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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, 2025

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.

• International Natura Clinic Center LLC

  • Internal Medicine Physician
  • Annandale, VA
  • NPI 1588941934

  DC

  Medicare reassignment NPD
• Nova Pain Management Center Inc

  dba Nova Medical Center

  • Internal Medicine Physician
  • Fairfax, VA
  • NPI 1245812825

  DC

  Medicare reassignment NPD
• Sun Medical Center, LLC

  • Primary Care Clinic/Center
  • Annandale, VA
  • NPI 1871970574

  DC

  Medicare reassignment NPD
• Sun Medical LLC

  • Internal Medicine Physician
  • Fairfax, VA
  • NPI 1255123170

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1619826476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "571-407-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "571-407-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024195870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jin Hyuk Park, M.D.
• Jonathan J Park, D.M.D.,M.D.
• Juliana Youngmin Park, M.D.
• Lisa L Park, MD
• Makenna Park
• Pamela Park, OTR
• Patricia S. Park, SLP
• Priscilla J Park
• Songki Park, NP
• Soo Woong Park, M.D.

• Family Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.