1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

CHANJUN PARK
NPI 1487401436
Student in an Organized Health Care Education/Training Program in Providence, RI

Active since May 06, 2024PECOS Enrolled
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-4741(401) 444-4445 Get Directions Write a Review

NPPES record last updated: May 29, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Chanjun Park NPPES

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

CHANJUN PARK (NPI 1487401436) is an individual student in an organized health care education/training program in Providence, Rhode Island, licensed in Rhode Island (LP06282) and active in the NPI registry since May 2024. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487401436
Entity TypeIndividual
Primary Taxonomy390200000X
Provider Legal NameCHANJUN PARK
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy StProvidence, RI 02903-4923 · (401) 444-4741 · Fax (401) 444-4445
Phone(401) 444-4741
Fax(401) 444-4445
Sole ProprietorNo
Enumeration DateMay 6, 2024
Last NPPES UpdateMay 29, 2024
NPPES CertifiedMay 29, 2024
✔ NPI 1487401436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in RI · LP06282
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
593 EDDY ST, Providence, RI 02903
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chanjun Park 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.

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.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRIAN CAO MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-4286
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695

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 Chanjun Park's NPI number?

The NPI number for Chanjun Park is 1487401436. It was assigned to this individual provider in the NPPES registry on May 6, 2024.

Where is Chanjun Park located?

Chanjun Park practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-4741.

What is Chanjun Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Chanjun Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Chanjun Park was last updated on May 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.