MOON JOON PARK MD
NPI 1083293112
Internal Medicine - Sleep Medicine in Fresno, CA

Q: What is Moon Park's NPI number?

The NPI number for Moon Park is 1083293112. It was assigned to this individual provider in the NPPES registry on April 6, 2021.

Q: What is Moon Park's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sleep Medicine, with taxonomy code 207RS0012X.

Q: When was this NPI record last updated?

The NPPES record for Moon Park was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 06, 2021PECOS EnrolledAccepts Medicare Assignment

6733 N WILLOW AVE STE 107, FRESNO, CA 93710(559) 435-4700(559) 298-7951 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 2, 2025, Feb 25, 2025, Apr 6, 2021 (3 updates tracked since 2021).

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About Moon Joon Park Md NPPES

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

MOON JOON PARK MD (NPI 1083293112) is an individual sleep medicine provider in Fresno, California, licensed in California (A192818) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fresno, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1083293112

Entity TypeIndividualMale

Primary Taxonomy207RS0012X

Provider Legal NameMOON JOON PARKCredential: MD

Location Address6733 N WILLOW AVE STE 107Fresno, CA 93710-5953

Mailing Address1313 E Herndon AveFresno, CA 93720-3306

Phone(559) 435-4700

Fax(559) 298-7951

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 6, 2021

Last NPPES UpdateJune 2, 20253 updates tracked since enumeration

NPPES CertifiedJune 2, 2025

✔ NPI 1083293112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Sleep MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0012X

License✔ Licensed in CA · A192818

Definition

An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.

Also ListedHospitalistTaxonomy 208M00000X · License A192818 (CA)

6733 N WILLOW AVE STE 107, Fresno, CA 93710

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Secondary Practice Location 1

Location 11313 E Herndon AveFresno, CA 93720-3306 · Phone (559) 450-5372

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Moon Joon Park Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355862731

PECOS Enrollment IDI20250303001770

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 93710 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

$133.94 typical visit price

range $58.87 – $176.60

Typical copayment $33.48 (range $14.71 – $44.15)

Most-billed visit code 99204

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

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 12

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

LOURDES DELROSSO MD

Family Medicine (Sleep Medicine)