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PALISADES PARK MEDICINE, P.C.
NPI 1093080871
Internal Medicine in Palisades Park, NJ

Active since March 13, 2012
340 BROAD AVE, PALISADES PARK, NJ 07650(201) 592-1112 Get Directions Write a Review

NPPES record last updated: March 13, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Palisades Park Medicine, P.c. NPPES

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

PALISADES PARK MEDICINE, P.C. (NPI 1093080871) is a healthcare organization registered as an internal medicine in Palisades Park, New Jersey and active in the NPI registry since March 2012. The organization lists Kyungkon Kenneth Choi, Owner, as its authorized official.

NPPES Registry Identity

NPI1093080871
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePALISADES PARK MEDICINE, P.C.
Location Address340 BROAD AVEPalisades Park, NJ 07650-2618
Mailing Address340 Broad AvePalisades Park, NJ 07650-2618 · (201) 592-1112
Phone(201) 592-1112
Organization SubpartNo
Authorized OfficialKyungkon Kenneth ChoiOwner · (201) 638-8156
Enumeration DateMarch 13, 2012
✔ NPI 1093080871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 2MA05329300
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
340 BROAD AVE, Palisades Park, NJ 07650
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Other Identifiers 3

Medicaid7179405NJ
Medicare PINF35218NJ
Medicare UPINF35218NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Palisades Park Medicine, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew JerseyEnrollment IDO20120416000127Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Palisades Park Medicine, P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Kyungkon Choi, MD
Internal Medicine
NPI 1760579064
340 BROAD AVE
Palisades Park, NJ 07650
(201) 592-1112
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Palisades Park Medicine, P.C.'s NPI number?

The NPI number for Palisades Park Medicine, P.C. is 1093080871. It was assigned to this organization in the NPPES registry on March 13, 2012.

Where is Palisades Park Medicine, P.C. located?

Palisades Park Medicine, P.C. is located at 340 Broad Ave, Palisades Park, NJ 07650. The listed phone number is (201) 592-1112.

What is Palisades Park Medicine, P.C.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Palisades Park Medicine, P.C. enrolled in Medicare?

Yes. Palisades Park Medicine, P.C. is registered in the Medicare PECOS enrollment system.

When is Palisades Park Medicine, P.C.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Palisades Park Medicine, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Palisades Park Medicine, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Palisades Park Medicine, P.C. was last updated on March 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.