MICHELLE PARK - NPI 1073254207 - Pediatrics in Jacksonville, FL

Q: What is the provider's specialty?

The provider's specialty is Pediatrics with taxonomy code 208000000X.

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About Michelle Park NPPES

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

MICHELLE PARK (NPI 1073254207) is an individual pediatrics provider in Jacksonville, Florida, licensed in Florida (OS22077) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Alabama College Of Osteopathic Medicine (2022).

NPPES Registry Identity

NPI1073254207

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameMICHELLE PARK

Location Address6015 118TH STJacksonville, FL 32244-3703

Mailing AddressPo Box 4408Jacksonville, FL 32231-4008 · (904) 633-0610 · Fax (904) 633-0611

Phone(904) 633-0610

Fax(904) 633-0611

Sole ProprietorNo

Medical School CMSAlabama College Of Osteopathic MedicineGraduated 2022

Enumeration DateApril 3, 2022

Last NPPES UpdateJuly 6, 20263 updates tracked since enumeration

NPPES CertifiedJuly 6, 2026

✔ NPI 1073254207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in FL · OS22077

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.

6015 118TH ST, Jacksonville, FL 32244

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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)

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

PECOS PAC ID1850860503

PECOS Enrollment IDI20260512002810

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 32244 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 7

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

DR. SOFIA MUENYI MD

Family Medicine