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JUSTINA PARK
NPI 1033090345
Nurse Practitioner - Acute Care in New York, NY

Active since September 11, 2025PECOS Enrolled
622 W 168TH ST, NEW YORK, NY 10032(212) 305-4550 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Justina Park NPPES

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

JUSTINA PARK (NPI 1033090345) is an individual acute care provider in New York, New York, licensed in New York (433409) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1033090345
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameJUSTINA PARK
Location Address622 W 168TH STNew York, NY 10032-3720
Mailing Address60 Chaffee CirNorwood, NJ 07648-1248 · (201) 916-6611
Phone(212) 305-4550
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 11, 2025
NPPES CertifiedSeptember 11, 2025
✔ NPI 1033090345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in NY · 433409
622 W 168TH ST, New York, NY 10032
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justina Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032698295
PECOS Enrollment IDI20260209000526
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.

Medicare Billing Reassignment

Medicare enrollment records show Justina Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York University
1,046 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 7,712 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10032 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. PIETRO ALESSANDRO AMBROGIO CANETTA M.D.
Internal Medicine (Nephrology)
622 W 168TH ST, PH4-124
NEW YORK, NY 10032
New York County (212) 305-5020
CHARLES D RESOR
Internal Medicine
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-2913
MR. CALVIN KAILUN LEE NP
Nurse Practitioner (Adult Health)
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-0914
DI FAN CONEYBEARE M.D.
Emergency Medicine
622 W 168TH ST
NEW YORK, NY 10032
New York County (760) 808-2557
JONATHAN LE PHARM.D.
Pharmacist
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 342-8645
ASHLEE A CAMPBELL
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100
DR. EMILY SPIERA MD, MPH
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6262
SAAGAR MADHAV PANDE
Student in an Organized Health Care Education/Training Program
622 W 168TH ST
NEW YORK, NY 10032
New York County (212) 305-6100

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 Justina Park's NPI number?

The NPI number for Justina Park is 1033090345. It was assigned to this individual provider in the NPPES registry on September 11, 2025.

Where is Justina Park located?

Justina Park practices at 622 W 168th St, New York, NY 10032. The listed phone number is (212) 305-4550.

What is Justina Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Justina Park enrolled in Medicare?

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

Which organization bills Medicare for Justina Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justina Park reassigns Medicare benefits to New York University (Boynton Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justina Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Justina Park was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.