DR. JOHN ARCHIBALD PARK M.D.
NPI 1154764017
Pediatrics - Pediatric Emergency Medicine in Valhalla, NY

Q: What is John Park's NPI number?

The NPI number for John Park is 1154764017. It was assigned to this individual provider in the NPPES registry on April 10, 2013.

Q: What is John Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for John Park was last updated on April 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 10, 2013PECOS Enrolled

100 WOODS RD, VALHALLA, NY 10595(914) 493-7000 Get Directions Write a Review

NPPES record last updated: April 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. John Archibald Park M.d. NPPES

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

DR. JOHN ARCHIBALD PARK M.D. (NPI 1154764017) is an individual pediatric emergency medicine provider in Valhalla, New York, licensed in New York (208088) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154764017

Entity TypeIndividualMale

Primary Taxonomy2080P0204X

Provider Legal NameDR. JOHN ARCHIBALD PARKCredential: M.D.

Location Address100 WOODS RDValhalla, NY 10595-1530

Mailing Address162 Wyndcliffe RdScarsdale, NY 10583-4724 · (914) 574-1153

Phone(914) 493-7000

Sole ProprietorNo

Enumeration DateApril 10, 2013

Last NPPES UpdateApril 28, 2020

NPPES CertifiedApril 28, 2020

✔ NPI 1154764017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in NY · 208088

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License MD457144 (PA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

100 WOODS RD, Valhalla, NY 10595

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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)

Dr. John Archibald Park M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

MRS. LISA ANN SAUER N.P.

Nurse Practitioner (Neonatal, Critical Care)