Individual provider Active NPI

Chohee Park, FNP

  • Family Nurse Practitioner
  • Elmhurst, NY
National Provider Identifier
1881312924
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
349824 Issued in NY
Practice address
4012 80TH St
Elmhurst, NY 11373-1234
Phone
(718) 886-9000
Fax
(718) 961-0666
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 349824 NY Primary

Addresses

Primary practice location

4012 80TH St
Elmhurst, NY 11373-1234

Mailing address

4012 80TH St
Elmhurst, NY 11373-1234
Phone (718) 886-9000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230515002373 NY Practitioner - Nurse Practitioner 2264898329 Reassigns benefits to 1 organization
I20230517000349 NJ Practitioner - Nurse Practitioner 2264898329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

2175 Lemoine Ave
FL 6
Fort Lee, NJ 07024-6008
Phone (201) 886-9000

4012 80TH St
Elmhurst, NY 11373-1234
Phone (718) 886-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
349824NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Dermatology of NJ,PA CurrentSince Apr 5, 2023 Accepting new patients
Metro Dermatology of Ny,PC CurrentSince Apr 26, 2023 Accepting new patients

Locations

2175 Lemoine Ave
Fort Lee, NJ 07024
Phone (201) 585-4612

2175 Lemoine Ave
Fl 6
Fort Lee, NJ 07024
Phone (201) 585-4612

119 E Fordham Rd
Bronx, NY 10468
Phone (718) 886-9000

220 E 161st St
Bronx, NY 10451
Phone (718) 537-5000

4012 80th St
Elmhurst, NY 11373
Phone (718) 426-9595

14472 Northern Blvd
Ste 203
Flushing, NY 11354
Phone 7188869000 ext. 69000

4161 Kissena Blvd
Ste 5
Flushing, NY 11355
Phone (718) 886-6666

25707 Union Tpke
Glen Oaks, NY 11004
Phone (718) 343-0070

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1881312924",
    "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",
            "fax_number": "718-961-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4012 80TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731234",
            "telephone_number": "718-886-9000",
            "fax_number": "718-961-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHOHEE",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "349824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.