JINA PARK MD
NPI 1093179517
Pediatrics - Neonatal-Perinatal Medicine in Walnut Creek, CA

Q: What is Jina Park's NPI number?

The NPI number for Jina Park is 1093179517. It was assigned to this individual provider in the NPPES registry on April 11, 2016.

Q: What is Jina Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Jina Park was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 11, 2016PECOS Enrolled

1425 S MAIN ST, WALNUT CREEK, CA 94596(510) 752-1000 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jina Park Md NPPES

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

JINA PARK MD (NPI 1093179517) is an individual neonatal-perinatal medicine provider in Walnut Creek, California, licensed in California (152646) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (2016).

NPPES Registry Identity

NPI1093179517

Entity TypeIndividualFemale

Primary Taxonomy2080N0001X

Provider Legal NameJINA PARKCredential: MD

Location Address1425 S MAIN STWalnut Creek, CA 94596-5318

Mailing Address1425 S Main StWalnut Creek, CA 94596-5318

Phone(510) 752-1000

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2016

Enumeration DateApril 11, 2016

Last NPPES UpdateSeptember 12, 2023

NPPES CertifiedSeptember 12, 2023

✔ NPI 1093179517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in CA · 152646

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

1425 S MAIN ST, Walnut Creek, CA 94596

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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)

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

PECOS PAC ID4587929799

PECOS Enrollment IDI20260427001136

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.

Other Providers at the Same Location NPPES 20

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

BROOK ANDREW WOOLLEY M.D.

Emergency Medicine

1425 S MAIN ST, EMERGENCY MEDICINE DEPARTMENT
WALNUT CREEK, CA 94596

Contra Costa County (925) 295-5100

DR. THOMAS CRESANTE D.O.

Hospitalist

1425 S MAIN ST, KAISER PERMANENTE WALNUT CREEK ATTN: HBS DEPT
WALNUT CREEK, CA 94596

Contra Costa County (925) 295-4643

SARA WON MD

Obstetrics & Gynecology