DANIEL JUN PARK M.D.
NPI 1063875292
Pediatrics in Tyler, TX

Q: What is Daniel Park's NPI number?

The NPI number for Daniel Park is 1063875292. It was assigned to this individual provider in the NPPES registry on April 4, 2016.

Q: What is Daniel Park's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Park was last updated on March 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since April 04, 2016PECOS Enrolled

8288 S BROADWAY AVE, TYLER, TX 75703(903) 606-7060(903) 606-7129 Get Directions Write a Review

NPPES record last updated: March 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 17, 2026, Sep 20, 2024, May 10, 2024 and 1 more (4 updates tracked since 2021).

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About Daniel Jun Park M.d. NPPES

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

DANIEL JUN PARK M.D. (NPI 1063875292) is an individual pediatrics provider in Tyler, Texas, licensed in Texas (S0046) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063875292

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDANIEL JUN PARKCredential: M.D.

Location Address8288 S BROADWAY AVETyler, TX 75703-5262

Mailing Address8288 S Broadway AveTyler, TX 75703-5262 · (903) 606-7060 · Fax (903) 606-7129

Phone(903) 606-7060

Fax(903) 606-7129

Sole ProprietorNo

Enumeration DateApril 4, 2016

Last NPPES UpdateMarch 17, 20264 updates tracked since enumeration

NPPES CertifiedMarch 17, 2026

✔ NPI 1063875292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in TX · S0046

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

8288 S BROADWAY AVE, Tyler, TX 75703

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Daniel Jun 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.

Medicare Billing Reassignment

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

Christus Trinity Clinic Texas

6.0 mi

Family Medicine

520 DOUGLAS BLVD
Tyler, TX 75702

Reassigned Medicare billing, Texas enrollment
2,745 clinicians in this Medicare group

NPI 1285684225 (903) 315-4119

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 75703 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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 15

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

DR. JOHN W SCROGGINS MD

Family Medicine