DR. INNJEA PARK DPM
NPI 1174907992
Podiatrist - Foot & Ankle Surgery in Staten Island, NY

Q: What is Innjea Park's NPI number?

The NPI number for Innjea Park is 1174907992. It was assigned to this individual provider in the NPPES registry on July 10, 2015.

Q: What is Innjea Park's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Q: When was this NPI record last updated?

The NPPES record for Innjea Park was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 July 10, 2015PECOS EnrolledAccepts Medicare Assignment

1042 HUGUENOT AVE, STATEN ISLAND, NY 10312(917) 796-1693 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 7, 2025, Apr 12, 2018 (2 updates tracked since 2018).

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About Dr. Innjea Park Dpm NPPES

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

DR. INNJEA PARK DPM (NPI 1174907992) is an individual foot & ankle surgery provider in Staten Island, New York, licensed in New York (N006887) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS, is affiliated with Staten Island University Hospital, and is a graduate of New York College Of Podiatric Medicine (2015).

NPPES Registry Identity

NPI1174907992

Entity TypeIndividualMale

Primary Taxonomy213ES0103X

Provider Legal NameDR. INNJEA PARKCredential: DPM

Location Address1042 HUGUENOT AVEStaten Island, NY 10312-4315

Mailing Address1042 Huguenot AveStaten Island, NY 10312-4315 · (917) 796-1693

Phone(917) 796-1693

Sole ProprietorNo

Medical School CMSNew York College Of Podiatric MedicineGraduated 2015

Enumeration DateJuly 10, 2015

Last NPPES UpdateMay 7, 20252 updates tracked since enumeration

NPPES CertifiedMay 7, 2025

✔ NPI 1174907992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in NY · N006887

1042 HUGUENOT AVE, Staten Island, NY 10312

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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 and accepts Medicare assignment

Dr. Innjea Park Dpm 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 ID2860742020

PECOS Enrollment IDI20180910000684

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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

283 services121 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

57 services41 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

49 services34 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

39 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

15 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Staten Island University Hospital

Acute Care Hospitals · Staten Island, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330160

Location475 Seaview AvenueStaten Island, NY 10305 · Richmond County

Emergency services Birthing friendly

Wyckoff Heights Medical Center

Acute Care Hospitals · Brooklyn, NY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330221

Location374 Stockholm StreetBrooklyn, NY 11237 · Kings County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 5

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

PHYSICIANS OF UNIVERSITY HOSPITAL PC

Allergy & Immunology