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JIN HYUK PARK M.D.
NPI 1306824909
Pediatrics - Pediatric Cardiology in Fairfax, VA

Active since January 04, 2006PECOS Enrolled
8500 EXECUTIVE PARK AVE STE 110, FAIRFAX, VA 22031(703) 573-0504(703) 573-4856 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Jul 7, 2017, Jan 10, 2017 (3 updates tracked since 2017).

About Jin Hyuk Park M.d. NPPES

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

JIN HYUK PARK M.D. (NPI 1306824909) is an individual pediatric cardiology provider in Fairfax, Virginia, licensed in Virginia (0101232879) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306824909
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameJIN HYUK PARKCredential: M.D.
Location Address8500 EXECUTIVE PARK AVE STE 110Fairfax, VA 22031-2228
Mailing Address8500 Executive Park Ave, Suite 110Fairfax, VA 22031-2225 · (703) 573-0504 · Fax (703) 573-4856
Phone(703) 573-0504
Fax(703) 573-4856
Sole ProprietorNo
Enumeration DateJanuary 4, 2006
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1306824909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in VA · 0101232879
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
8500 EXECUTIVE PARK AVE STE 110, Fairfax, VA 22031
Open in Google Maps ↗

Other Identifiers 1

Medicaid006736262VA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jin Hyuk 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jin Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Inova Health Care Services
0.7 mi
Multi-Specialty
2740 PROSPERITY AVE STE 200
Fairfax, VA 22031
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 2,618 clinicians in this Medicare group
NPI 1669511051 (703) 321-2600
Children's Hospital
13 mi
Pediatrics
111 MICHIGAN AVE NW
Washington, DC 20010
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,417 clinicians in this Medicare group
NPI 1780800128 (202) 476-5000

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

Other Providers at the Same Location NPPES

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

SARAH ANN CHAMBERS GURSON M.D.
Pediatrics (Pediatric Cardiology)
8500 EXECUTIVE PARK AVE STE 110
FAIRFAX, VA 22031
Fairfax County (703) 573-0504

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 Jin Park's NPI number?

The NPI number for Jin Park is 1306824909. It was assigned to this individual provider in the NPPES registry on January 4, 2006.

Where is Jin Park located?

Jin Park practices at 8500 Executive Park Ave Ste 110, Fairfax, VA 22031. The listed phone number is (703) 573-0504.

What is Jin Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Jin Park enrolled in Medicare?

Yes. Jin Park is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jin Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jin Park reassigns Medicare benefits to 2 organizations: Inova Health Care Services (Fairfax, VA) and Children's Hospital (Washington, DC). 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 Jin Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jin Park was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.