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JASON PARK MD
NPI 1063153534
Student in an Organized Health Care Education/Training Program in Waterbury, CT

Active since April 06, 2022PECOS Enrolled
160 ROBBINS ST, WATERBURY, CT 06708(213) 219-8559(203) 573-7031 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jason Park Md NPPES

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

JASON PARK MD (NPI 1063153534) is an individual student in an organized health care education/training program in Waterbury, Connecticut and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063153534
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJASON PARKCredential: MD
Location Address160 ROBBINS STWaterbury, CT 06708-2652
Mailing Address64 Robbins StWaterbury, CT 06708-2600 · (203) 573-6162 · Fax (203) 573-6707
Phone(213) 219-8559
Fax(203) 573-7031
Sole ProprietorNo
Enumeration DateApril 6, 2022
NPPES CertifiedApril 6, 2022
✔ NPI 1063153534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

160 ROBBINS ST, Waterbury, CT 06708
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason Park Md 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.

VALERIIA DINDIKOVA MD
Student in an Organized Health Care Education/Training Program
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
RYAN MCLEAN MD
Student in an Organized Health Care Education/Training Program
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
DR. MARIA TASSO M.D.
Pediatrics
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 755-2999
ARVIN FARHANG MD
Student in an Organized Health Care Education/Training Program
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
HIBA ZEID
Internal Medicine (Pulmonary Disease)
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
CHRYSTEL PAWLY MD
Student in an Organized Health Care Education/Training Program
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 573-7284
ELIZABETH MARIE BAILEY GEIB MD
Pediatrics
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 755-2999
DR. ELLEN MASCOLI-LANZA M.D.
Pediatrics
160 ROBBINS ST
WATERBURY, CT 06708
Naugatuck Valley Planning Region (203) 755-2999

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 Jason Park's NPI number?

The NPI number for Jason Park is 1063153534. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Jason Park located?

Jason Park practices at 160 Robbins St, Waterbury, CT 06708. The listed phone number is (213) 219-8559.

What is Jason Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jason Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jason Park was last updated on April 6, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.