CHARLIE JOON PARK CRNA
NPI 1396409660
Nurse Anesthetist, Certified Registered in Fort Worth, TX

Active since October 23, 2021Accepts Medicare Assignment
801 7TH AVE, FORT WORTH, TX 76104(682) 885-4054(682) 885-7497 Get Directions Write a Review

NPPES record last updated: March 2, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 2, 2022, Jan 25, 2022, Oct 23, 2021 (3 updates tracked since 2021).

About Charlie Joon Park Crna NPPES

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

CHARLIE JOON PARK CRNA (NPI 1396409660) is an individual nurse anesthetist, certified registered in Fort Worth, Texas, licensed in Texas (1065201) and active in the NPI registry since October 2021. He is affiliated with Cook Childrens Medical Center and is a graduate of Other (2021).

NPPES Registry Identity

NPI1396409660
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameCHARLIE JOON PARKCredential: CRNA
Location Address801 7TH AVEFort Worth, TX 76104-2733
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-6483 · Fax (682) 885-3113
Fax(682) 885-7497
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 23, 2021
Last NPPES UpdateMarch 2, 20223 updates tracked since enumeration
NPPES CertifiedMarch 2, 2022
NPI 1396409660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in TX · 1065201
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

801 7TH AVE, Fort Worth, TX 76104

Accepted 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

Charlie Joon Park Crna 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 ID3678965662
PECOS Enrollment IDI20220125002075

Hospital Affiliations CMS Care Compare

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

Cook Childrens Medical Center

Childrens · Fort Worth, TX
OwnershipVoluntary non-profit - Private
CMS Certification Number453300
Location801 Seventh AvenueFort Worth, TX 76104 · Tarrant County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$129.63 typical visit price
range $56.47 – $171.07
Typical copayment $32.40 (range $14.11 – $42.76)
Most-billed visit code 99204
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
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.

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.

Anesthesiology
801 7TH AVE
FORT WORTH, TX 76104
Pharmacist
801 7TH AVE
FORT WORTH, TX 76104
Nurse Anesthetist, Certified Registered
801 7TH AVE
FORT WORTH, TX 76104
Pediatrics (Neonatal-Perinatal Medicine)
801 7TH AVE, COOK CHILDRENS, DEPT OF NEONATOLOGY
FORT WORTH, TX 76104
Pediatrics (Neonatal-Perinatal Medicine)
801 7TH AVE
FORT WORTH, TX 76104
Pediatrics (Neonatal-Perinatal Medicine)
801 7TH AVE
FORT WORTH, TX 76104
Pediatrics (Neonatal-Perinatal Medicine)
801 7TH AVE
FORT WORTH, TX 76104
Pediatrics (Neonatal-Perinatal Medicine)
801 7TH AVE
FORT WORTH, TX 76104

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 Charlie Park's NPI number?

The NPI number for Charlie Park is 1396409660. It was assigned to this individual provider in the NPPES registry on October 23, 2021.

Where is Charlie Park located?

Charlie Park practices at 801 7th Ave, Fort Worth, TX 76104. The listed phone number is (682) 885-4054.

What is Charlie Park's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Charlie Park enrolled in Medicare?

Yes. Charlie 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.

What insurance does Charlie Park accept?

Health plans from Imperial Insurance Companies, Inc. list Charlie Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Charlie Park affiliated with any hospitals?

According to CMS data, Charlie Park is affiliated with Cook Childrens Medical Center.

When was this NPI record last updated?

The NPPES record for Charlie Park was last updated on March 2, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.