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SOO JUNG PARK PA-C
NPI 1225836844
Physician Assistant in Dulles, VA

Active since March 07, 2025PECOS EnrolledAccepts Medicare Assignment
24430 STONE SPRINGS BLVD SUITE 275, DULLES, VA 20166(703) 858-3220 Get Directions Write a Review

NPPES record last updated: August 29, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Soo Jung Park Pa-c NPPES

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

SOO JUNG PARK PA-C (NPI 1225836844) is an individual physician assistant in Dulles, Virginia, licensed in Virginia (0110010844) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS, is affiliated with Inova Loudoun Hospital, and maintains a secondary practice location in Harrisonburg.

NPPES Registry Identity

NPI1225836844
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSOO JUNG PARKCredential: PA-C
Location Address24430 STONE SPRINGS BLVD SUITE 275Dulles, VA 20166-2270
Mailing Address224-d Cornwall Street, Nw, Suite 403Leesburg, VA 20176-2704 · (703) 737-6010
Phone(703) 858-3220
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 7, 2025
Last NPPES UpdateAugust 29, 2025
NPPES CertifiedAugust 29, 2025
✔ NPI 1225836844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in VA · 0110010844
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
24430 STONE SPRINGS BLVD SUITE 275, Dulles, VA 20166
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Other Names 1

Other Name (5)Crystal Park Pa-c

Secondary Practice Location 1

Location 1Msc 4315 235 Martin Luther King Jr WayHarrisonburg, VA 22807-0001 · Phone (540) 568-7658

Other Identifiers 1

Medicaid30018274670001VA

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

Soo Jung Park Pa-c 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 ID2961914593
PECOS Enrollment IDI20250620000776
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.

Hospital Affiliations CMS Care Compare

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

Inova Loudoun Hospital

Acute Care Hospitals · Leesburg, VA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490043
Location44045 Riverside ParkwayLeesburg, VA 20176 · Loudoun County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20166 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Soo Jung Park's NPI number?

The NPI number for Soo Jung Park is 1225836844. It was assigned to this individual provider in the NPPES registry on March 7, 2025. The provider is also known as Crystal Park Pa-C.

Where is Soo Jung Park located?

Soo Jung Park practices at 24430 Stone Springs Blvd Suite 275, Dulles, VA 20166. The listed phone number is (703) 858-3220.

What is Soo Jung Park's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Soo Jung Park enrolled in Medicare?

Yes. Soo Jung 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.

Is Soo Jung Park affiliated with any hospitals?

According to CMS data, Soo Jung Park is affiliated with Inova Loudoun Hospital.

When was this NPI record last updated?

The NPPES record for Soo Jung Park was last updated on August 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.