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

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: October 25, 2026.

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

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 Wyckoff Heights Medical Center, 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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Innjea Park reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mbip Podiatry P.C.
Same address
Foot & Ankle Surgery
1042 HUGUENOT AVE
Staten Island, NY 10312
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Mbip Podiatry PC
  • 4 clinicians in this Medicare group
NPI 1992426969 (718) 317-5215
Seaview Podiatry P.C.
7.6 mi
Podiatric
970 BARD AVE
Staten Island, NY 10301
  • Reassigned Medicare billing, New York enrollment
  • 5 clinicians in this Medicare group
NPI 1326446055 (201) 658-2526
Fit Feet Podiatry P.C.
12 mi
Foot & Ankle Surgery
3111 BRIGHTON 2ND ST, L2
Brooklyn, NY 11235
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Fit Feet Podiatry PC
  • 6 clinicians in this Medicare group
NPI 1588747893 (718) 332-8633
Wyckoff Professional Medical Services, PC
19 mi
Internal Medicine
374 STOCKHOLM ST
Brooklyn, NY 11237
  • Reassigned Medicare billing, New York enrollment
  • 427 clinicians in this Medicare group
NPI 1659710796 (718) 963-6485

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

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
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.
15 services12 patients

Hospital Affiliations CMS Care Compare

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

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
1042 HUGUENOT AVE
STATEN ISLAND, NY 10312
Richmond County (718) 317-7556
MARIANNE LANTS DPM, P.C.
Podiatrist (Foot & Ankle Surgery)
1042 HUGUENOT AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3838
HOLTZER PHYSICAL THERAPY PLLC
Physical Therapist
1042 HUGUENOT AVE
STATEN ISLAND, NY 10312
Richmond County (732) 344-2192
DR. MARIANNE LANTS D.P.M.
Podiatrist (Foot Surgery)
1042 HUGUENOT AVE
STATEN ISLAND, NY 10312
Richmond County (718) 948-3838
MBIP PODIATRY P.C.
Podiatrist (Foot & Ankle Surgery)
1042 HUGUENOT AVE
STATEN ISLAND, NY 10312
Richmond County (718) 317-5215

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 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.

Where is Innjea Park located?

Innjea Park practices at 1042 Huguenot Ave, Staten Island, NY 10312. The listed phone number is (917) 796-1693.

What is Innjea Park's specialty?

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

Is Innjea Park enrolled in Medicare?

Yes. Innjea Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Innjea Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Innjea Park reassigns Medicare benefits to 4 organizations: Mbip Podiatry P.C. (Staten Island, NY), Seaview Podiatry P.C. (Staten Island, NY), Fit Feet Podiatry P.C. (Brooklyn, NY) and Wyckoff Professional Medical Services, PC (Brooklyn, NY). Each 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 Innjea Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Innjea Park affiliated with any hospitals?

According to CMS data, Innjea Park is affiliated with Wyckoff Heights Medical Center.

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 17 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.