Active NPI
Misun Park Sim, NP
- Adult Health Nurse Practitioner
- Pittsburgh, PA
National Provider Identifier
1639589047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- SP013516
- Practice address
- 3000 Park Lane Drive
Pittsburgh, PA 15275-5620 - Phone
- (773) 292-4800
- Fax
- (312) 564-4059
- NPI assigned
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | SP013516 | PA | Primary |
Addresses
Primary practice location
3000 Park Lane Drive
Pittsburgh, PA 15275-5620
Mailing address
730 Cool Springs Blvd Ste 500
Franklin, TN 37067-7331
Phone (773) 292-4800
Other names 1
- Mi Sun Park
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP013516 | PA | MD | Adult Health Nurse Practitioner |
Interoperability endpoints
- misun.sim.p2@direct.alegiscare.nextgenshare.com
- misun.park.p2@direct.alegiscare.nextgenshare.com
- msim33370@evernorth.direct-ci.com
- misun.park.p1@direct.alegiscare.nextgenshare.com
Organizations & group practices 1
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.
-
- General Practice Physician
- Philadelphia, PA
- NPI 1326093675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1639589047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 COOL SPRINGS BLVD STE 500",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370677331",
"telephone_number": "773-292-4800",
"fax_number": "312-564-4059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 PARK LANE DRIVE",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152755620",
"telephone_number": "773-292-4800",
"fax_number": "312-564-4059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIM",
"first_name": "MISUN",
"middle_name": "PARK",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2024-05-07",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "SP013516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MI SUN",
"last_name": "PARK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.