1. Home
  2. Directory
  3. Texas
  4. Tyler
  5. Pediatrics
  6. NPI Profile

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

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: August 02, 2026.

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

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
Open in Google Maps ↗

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.Insurance ›

Medicare Participation & PECOS CMS

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

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.

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
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
ANDREA M ELLIS MD
Family Medicine
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
DR. ROY BRENT WADLE D.O.
Family Medicine
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
KURT NIELSEN MD
Emergency Medicine
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
JOHN JASON PAGE DO, PA
Family Medicine
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
SONJA FAYE TILLER FNP-C
Nurse Practitioner (Family)
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
GALE JEANNIE HOBSON M.D.
Family Medicine
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060
KENT MATTHEW DAVIS MD
Internal Medicine (Geriatric Medicine)
8288 S BROADWAY AVE
TYLER, TX 75703
Smith County (903) 606-7060

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 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.

Where is Daniel Park located?

Daniel Park practices at 8288 S Broadway Ave, Tyler, TX 75703. The listed phone number is (903) 606-7060.

What is Daniel Park's specialty?

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

Is Daniel Park enrolled in Medicare?

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

What insurance does Daniel Park accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and Molina Healthcare list Daniel Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

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 4 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.