Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MICHELLE PARK
NPI 1073254207
Pediatrics in Jacksonville, FL

Q: What is Michelle Park's NPI number?

The NPI number for Michelle Park is 1073254207. It was assigned to this individual provider in the NPPES registry on April 3, 2022.

Q: What is Michelle 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 Michelle Park was last updated on July 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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 03, 2022PECOS Enrolled

6015 118TH ST, JACKSONVILLE, FL 32244(904) 633-0610(904) 633-0611 Get Directions Write a Review

NPPES record last updated: July 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 6, 2026, Apr 16, 2026, Apr 7, 2026 (3 updates tracked since 2026).

On this page

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

Open in Google Maps ↗

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