Hyeyoon Hannah Park

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F307577-1 Issued in NY

Practice address

14472 Northern Blvd Ste 203
Flushing, NY 11354-4231

Phone

(718) 886-9000

NPI assigned

Jan 28, 2016

Sex

Female

Sole proprietor

Yes

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 NY, NJ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Dermatology of NJ,PAGroup PAC ID 5698737021, 5 clinicians

Metro Dermatology of Ny,P.C.Group PAC ID 3779761705, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• Metro Dermatology of Ny,PC

  • Physician Assistant
  • Flushing, NY
  • NPI 1336343268
  Medicare reassignment Care Compare group NPD
• Metro Dermatology of NJ,PA

  • Procedural Dermatology Physician
  • Fort Lee, NJ
  • NPI 1437353372
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1760840201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4012 80TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731234",
            "telephone_number": "718-886-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14472 NORTHERN BLVD STE 203",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544231",
            "telephone_number": "718-886-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 E 161st St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104513543",
            "country_code": "US",
            "telephone_number": "718-886-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4012 80th St",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113731234",
            "country_code": "US",
            "telephone_number": "718-886-9000 x4008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Grand Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076314968",
            "country_code": "US",
            "telephone_number": "201-886-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2175 Lemoine Ave Fl 6",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "NJ",
            "postal_code": "070246008",
            "country_code": "US",
            "telephone_number": "201-886-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "HYEYOON",
        "middle_name": "HANNAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307577-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Park
• Hannah Park, OTR/L
• Ho Jung Park
• Hui Byung Park, DDS
• Hwajin Park
• Hyun Dong Park, MD
• In Sook Park, L.AC
• Jaehyoung Park
• James Park
• Jason Park, R.PH.

• Adult Health Nurse Practitioner in Flushing, NY
• Providers in Flushing, 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 Mar 1, 2022; 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.