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DR. JEANNY KIM PARK M.D.
NPI 1023090206
Pediatrics - Pediatric Cardiology in Sacramento, CA

Active since November 15, 2005PECOS Enrolled
2516 STOCKTON BLVD, SACRAMENTO, CA 95817(916) 734-3589(916) 734-0424 Get Directions Write a Review

NPPES record last updated: October 25, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jeanny Kim Park M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEANNY KIM PARK M.D. (NPI 1023090206) is an individual pediatric cardiology provider in Sacramento, California, licensed in California (G68672) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023090206
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameDR. JEANNY KIM PARKCredential: M.D.
Location Address2516 STOCKTON BLVDSacramento, CA 95817-2208
Mailing Address2516 Stockton BlvdSacramento, CA 95817-2208 · (916) 734-3589 · Fax (916) 734-0424
Phone(916) 734-3589
Fax(916) 734-0424
Sole ProprietorNo
Enumeration DateNovember 15, 2005
Last NPPES UpdateOctober 25, 2007
✔ NPI 1023090206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in CA · G68672
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
2516 STOCKTON BLVD, Sacramento, CA 95817
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Other Identifiers 1

Medicare UPINF33270CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeanny Kim Park M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LENA CLAIRE VAN DER LIST D.O.
Pediatrics
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-2428
ALISON MY LAM M.D.
Pediatrics
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-3665
DR. ELIZABETH PARTRIDGE M.D.
Pediatrics (Pediatric Infectious Diseases)
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (510) 428-4337
SAMANTHA ELISE ELLINWOOD AUMAN M.D.
Student in an Organized Health Care Education/Training Program
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-2428
SARA BRUNDAGE DO
Pediatrics
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-3665
DR. DENNIS MICHAEL STYNE M.D.
Pediatrics (Pediatric Endocrinology)
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-0129
DR. ARUN RANJAN PANIGRAHI M.D.
Pediatrics (Pediatric Hematology-Oncology)
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-2781
DR. LESLIE YING CHIANG M.D.
Pediatrics (Pediatric Infectious Diseases)
2516 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-8118

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeanny Park's NPI number?

The NPI number for Jeanny Park is 1023090206. It was assigned to this individual provider in the NPPES registry on November 15, 2005.

Where is Jeanny Park located?

Jeanny Park practices at 2516 Stockton Blvd, Sacramento, CA 95817. The listed phone number is (916) 734-3589.

What is Jeanny Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Jeanny Park enrolled in Medicare?

Yes. Jeanny Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeanny Park was last updated on October 25, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.