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JEONG YEON KANG PARK
NPI 1447793450
Nurse Practitioner - Family in Tampa, FL

Active since November 22, 2016PECOS EnrolledAccepts Medicare Assignment
2203 N LOIS AVE STE 814, TAMPA, FL 33607(813) 608-5633(800) 608-5633 Get Directions Write a Review

NPPES record last updated: December 12, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 12, 2025, May 25, 2022, Nov 22, 2016 (3 updates tracked since 2016).

About Jeong Yeon Kang Park NPPES

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

JEONG YEON KANG PARK (NPI 1447793450) is an individual family provider in Tampa, Florida, licensed in Florida (ARNP9369012) and active in the NPI registry since November 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1447793450
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJEONG YEON KANG PARK
Location Address2203 N LOIS AVE STE 814Tampa, FL 33607-2388
Mailing Address2203 N Lois Ave Ste 814Tampa, FL 33607-2388 · (813) 608-5633 · Fax (800) 608-5633
Phone(813) 608-5633
Fax(800) 608-5633
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 22, 2016
Last NPPES UpdateDecember 12, 20253 updates tracked since enumeration
NPPES CertifiedDecember 12, 2025
✔ NPI 1447793450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · ARNP9369012
2203 N LOIS AVE STE 814, Tampa, FL 33607
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jeong Yeon Kang Park 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 ID3375972102
PECOS Enrollment IDI20200331000376
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

4

Medicare enrollment records show Jeong Yeon Park reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advanced Wound Care, LLC
Same address
Wound Care
2203 N LOIS AVE STE 814
Tampa, FL 33607
  • Reassigned Medicare billing, Florida enrollment
  • 31 clinicians in this Medicare group
NPI 1356036354 (813) 608-5633
Healnexxt Woundcare LLC
35 mi
Nurse Practitioner
211 E MAIN ST
Lakeland, FL 33801
  • Reassigned Medicare billing, Florida enrollment
  • 15 clinicians in this Medicare group
NPI 1942013032 (863) 860-8093
Wound Technology Network Inc
74 mi
Infectious Disease
5979 VINELAND RD STE 109
Orlando, FL 32819
  • Reassigned Medicare billing, Florida enrollment
  • 208 clinicians in this Medicare group
NPI 1962601393 (954) 923-7440
Wt Health Of Florida LLC
74 mi
Infectious Disease
5979 VINELAND RD STE 109
Orlando, FL 32819
  • Reassigned Medicare billing, Florida enrollment
  • 110 clinicians in this Medicare group
NPI 1982434106 (954) 923-7440

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 33607 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
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 3

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

MR. BRIAN KAIRALLA PA-C
Physician Assistant (Medical)
2203 N LOIS AVE STE 814
TAMPA, FL 33607
Hillsborough County (813) 608-5633
CHELSEA STEVENS MERCIER APRN
Nurse Practitioner (Family)
2203 N LOIS AVE STE 814
TAMPA, FL 33607
Hillsborough County (813) 608-5633
ADVANCED WOUND CARE, LLC
Registered Nurse (Wound Care)
2203 N LOIS AVE STE 814
TAMPA, FL 33607
Hillsborough County (813) 608-5633

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 Jeong Yeon Park's NPI number?

The NPI number for Jeong Yeon Park is 1447793450. It was assigned to this individual provider in the NPPES registry on November 22, 2016.

Where is Jeong Yeon Park located?

Jeong Yeon Park practices at 2203 N Lois Ave Ste 814, Tampa, FL 33607. The listed phone number is (813) 608-5633.

What is Jeong Yeon Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jeong Yeon Park enrolled in Medicare?

Yes. Jeong Yeon 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.

Which organizations bill Medicare for Jeong Yeon Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeong Yeon Park reassigns Medicare benefits to 4 organizations: Advanced Wound Care, LLC (Tampa, FL), Healnexxt Woundcare LLC (Lakeland, FL), Wound Technology Network Inc (Orlando, FL) and Wt Health Of Florida LLC (Orlando, FL). 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 Jeong Yeon 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 Jeong Yeon Park was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.