JONG HYUN PARK
NPI 1508493008
Pediatrics in Los Angeles, CA
About Jong Hyun Park NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JONG HYUN PARK (NPI 1508493008) is an individual pediatrics provider in Los Angeles, California, licensed in California (A186433) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jong Hyun Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jong Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- 13,921 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 90089 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.
LOS ANGELES, CA 90089
LOS ANGELES, CA 90089
LOS ANGELES, CA 90089
LOS ANGELES, CA 90089
LOS ANGELES, CA 90089
LOS ANGELES, CA 90089
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 Jong Park's NPI number?
The NPI number for Jong Park is 1508493008. It was assigned to this individual provider in the NPPES registry on March 25, 2020.
Where is Jong Park located?
Jong Park practices at 1200 N State St, Los Angeles, CA 90089. The listed phone number is (323) 409-1000.
What is Jong Park's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Jong Park enrolled in Medicare?
Yes. Jong Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jong Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jong Park reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, CA). 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 Jong 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 Jong Park was last updated on February 27, 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.
# Jong Hyun Park · NPI 1508493008
Pediatrics physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since March 25, 2020.
## Identity
- **NPI:** 1508493008 (Entity type: Individual)
- **Enumerated:** March 25, 2020
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** A186433 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1200 N STATE ST, Los Angeles, CA 90089-1001
- **Phone:** (323) 409-1000
## 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:** Southern California Permanente Medical Group (NPI 1134151657, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 27, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1508493008) · Data from the CMS NPPES public registry.