JOANN PARK MD
NPI 1316396906
Psychiatry & Neurology - Child & Adolescent Psychiatry in Indianapolis, IN

Q: What is Joann Park's NPI number?

The NPI number for Joann Park is 1316396906. It was assigned to this individual provider in the NPPES registry on June 6, 2016.

Q: What is Joann Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Joann Park was last updated on September 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 06, 2016PECOS EnrolledAccepts Medicare Assignment

1002 WISHARD BLVD STE 4110, INDIANAPOLIS, IN 46202(317) 944-8162(317) 944-8163 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 17, 2024, Jul 18, 2024, Sep 28, 2021 and 1 more (4 updates tracked since 2020).

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About Joann Park Md NPPES

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

JOANN PARK MD (NPI 1316396906) is an individual child & adolescent psychiatry provider in Indianapolis, Indiana, licensed in Indiana (01092460A) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Sacramento, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1316396906

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameJOANN PARKCredential: MD

Location Address1002 WISHARD BLVD STE 4110Indianapolis, IN 46202-4164

Mailing Address1002 Wishard Blvd Ste 4110Indianapolis, IN 46202-4164 · (317) 944-8162

Phone(317) 944-8162

Fax(317) 944-8163

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJune 6, 2016

Last NPPES UpdateSeptember 17, 20244 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2024

✔ NPI 1316396906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

Licenses✔ Licensed in IN · 01092460A✔ Licensed in CA · A151063

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 01092460A (IN)

1002 WISHARD BLVD STE 4110, Indianapolis, IN 46202

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Secondary Practice Location 1

Location 12230 Stockton BlvdSacramento, CA 95817-1353 · Phone (916) 734-2614

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Joann Park Md 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 ID547658684

PECOS Enrollment IDI20240725003006

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.

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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.

JANISE LORRAINE WINSTON LMHC

Counselor (Mental Health)