JI EUN PARK MD, MA
NPI 1417344417
Internal Medicine - Interventional Cardiology in Tucson, AZ
About Ji Eun Park Md, Ma NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JI EUN PARK MD, MA (NPI 1417344417) is an individual interventional cardiology provider in Tucson, Arizona, licensed in Arizona (70403) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ji Eun Park Md, Ma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ji Eun Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tucson, AZ 85745
- Reassigned Medicare billing, Arizona enrollment
- 293 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85723 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
TUCSON, AZ 85723
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 Ji Eun Park's NPI number?
The NPI number for Ji Eun Park is 1417344417. It was assigned to this individual provider in the NPPES registry on April 17, 2015.
Where is Ji Eun Park located?
Ji Eun Park practices at 3601 S 6th Ave, Tucson, AZ 85723. The listed phone number is (520) 792-1450.
What is Ji Eun Park's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Interventional Cardiology, with taxonomy code 207RI0011X.
Is Ji Eun Park enrolled in Medicare?
Yes. Ji Eun Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ji Eun Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ji Eun Park reassigns Medicare benefits to Tucson Physician Group Holdings, LLC (Tucson, AZ). The 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 Ji Eun Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ji Eun Park accept?
Health plans from Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Ji Eun 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.
When was this NPI record last updated?
The NPPES record for Ji Eun Park was last updated on July 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Ji Eun Park, MD, MA · NPI 1417344417
Interventional Cardiology physician in Tucson, Arizona. Individual provider, active in the CMS NPPES registry since April 17, 2015.
## Identity
- **NPI:** 1417344417 (Entity type: Individual)
- **Enumerated:** April 17, 2015
- **Primary specialty:** Internal Medicine - Interventional Cardiology · taxonomy 207RI0011X
- **State license:** 70403 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 3601 S 6TH AVE, Tucson, AZ 85723-0001
- **Phone:** (520) 792-1450
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Tucson Physician Group Holdings, LLC (NPI 1356726939, Tucson, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 1, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1417344417) · Data from the CMS NPPES public registry.