Individual provider Active NPI

Janet Jeong Park

  • Foot & Ankle Surgery Podiatrist
  • Bronx, NY
National Provider Identifier
1912536095
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00375100 Issued in NJ
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(347) 577-4410
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 25MD00375100 NJ Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

111 E 210TH St
Bronx, NY 10467-2401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230711002083 NJ Practitioner - Podiatry 8022477843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curalta Medical LLCGroup PAC ID 0749670453, 69 clinicians

Practice addresses (Care Compare)

1187 Main Ave
Clifton, NJ 07011-2252
Phone (973) 340-8970

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
83.84
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue21
Removal of skin lesions1-10
Removal of nail tissue35
Removal or shaving of skin growth17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Curalta Medical LLC Foot & Ankle Surgery CurrentSince Aug 15, 2023 Accepting new patients
Proactive Foot and Ankle Single Specialty CurrentSince Aug 15, 2023 Accepting new patients
Proactive Foot and Ankle CurrentSince Aug 15, 2023 Accepting new patients
Curalta Medical LLC Single Specialty CurrentSince Aug 15, 2023 Accepting new patients

Locations

350 Bloomfield Ave
Ste 5
Bloomfield, NJ 07003
Phone (973) 259-1490

1187 Main Ave
Ste 2D
Clifton, NJ 07011

1187 Main Ave
Clifton, NJ 07011
Phone (973) 340-8970

74 Pascack Rd
Ste 6
Park Ridge, NJ 07656
Phone (201) 291-1113

504 Hamburg Tpke
Ste 101
Wayne, NJ 07470
Phone (973) 956-8600

Organizations & group practices 4

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1912536095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "347-577-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JANET",
        "middle_name": "JEONG",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00375100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.