Chan W. Park, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD-16643 Issued in HI

Practice address

1 Jarrett White Road
Department of Surgery - 2 Oceanside
Honolulu, HI 96859

Phone

(808) 433-1730

NPI assigned

Jun 16, 2007

Sex

Male

Sole proprietor

No

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.

• Hawaii Surgery LLC

  • Surgery Physician
  • Honolulu, HI
  • NPI 1982420907

  HI, Surgery

  Medicare reassignment NPD Authorized official
• Pali Momi Medical Center

  • Multi-Specialty Clinic/Center
  • Aiea, HI
  • NPI 1275588329

  HI

  Medicare reassignment Care Compare group NPD
• Gastroenterology Associates, Inc

  • Specialist
  • Hilo, HI
  • NPI 1831202787

  HI

  Medicare reassignment NPD
• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969

  HI

  Medicare reassignment NPD
• Straub Clinic & Hospital

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1457306508

  HI

  Medicare reassignment NPD
• Pali Momi Medical Center

  • Community/Retail Pharmacy
  • Aiea, HI
  • NPI 1851364731
  Care Compare group NPD
• Pali Momi Medical Center

  • General Acute Care Hospital
  • Aiea, HI
  • NPI 1013961408
  Care Compare group
• Straub Clinic & Hospital

  • Community/Retail Pharmacy
  • Honolulu, HI
  • NPI 1295443216
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hilo Benioff Medical Center

  • General Acute Care Hospital
  • Hilo, HI
  • NPI 1780757856

  Hospital

  Care Compare affiliation
• Pali Momi Medical Center

  • General Acute Care Hospital
  • Aiea, HI
  • NPI 1013961408

  Hospital

  Care Compare affiliation

Specialty

General Surgery

Education

Jefferson Medical College of Thomas Jefferson University, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pali Momi Medical Center 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pali Momi Medical Center Hospital, Aiea, HI, CCN 120026
• Hilo Benioff Medical Center Hospital, Hilo, HI, CCN 120005

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 18, 2023.

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1720283153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 ALA MOANA BLVD APT 913",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151464",
            "telephone_number": "808-433-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE ROAD",
            "address_2": "DEPARTMENT OF SURGERY - 2 OCEANSIDE",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96859",
            "telephone_number": "808-433-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-16",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "HI",
            "license": "MD-16643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Park, RN, BSN
• Amanda Park
• Angela Park
• Angelyn Seol Park, PHARM D
• Carley Park
• Charlotte Park, DO
• Chay Linn N Park, PSY.D.
• Christina Ji Eun Park, MD
• Danny Ji Hoon Park
• Gavin H Park

• All providers in Honolulu, HI
• Surgery Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.