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MR. JIN WOO PARK M.D.
NPI 1548018609
Student in an Organized Health Care Education/Training Program in Roanoke, VA

Active since May 13, 2024PECOS Enrolled
2017 S. JEFFERSON ST. 1ST FLOOR, ROANOKE, VA 24014(540) 981-8025 Get Directions Write a Review

NPPES record last updated: July 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 26, 2024, May 13, 2024 (2 updates tracked since 2024).

About Mr. Jin Woo Park M.d. NPPES

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

MR. JIN WOO PARK M.D. (NPI 1548018609) is an individual student in an organized health care education/training program in Roanoke, Virginia and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548018609
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. JIN WOO PARKCredential: M.D.
Location Address2017 S. JEFFERSON ST. 1ST FLOORRoanoke, VA 24014
Mailing Address2017 S. Jefferson St. 1st FloorRoanoke, VA 24014 · (540) 981-8025
Phone(540) 981-8025
Sole ProprietorNo
Enumeration DateMay 13, 2024
Last NPPES UpdateJuly 26, 20242 updates tracked since enumeration
✔ NPI 1548018609 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
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.
2017 S. JEFFERSON ST. 1ST FLOOR, Roanoke, VA 24014
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Jin Woo Park M.d. 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.

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 Jin Woo Park's NPI number?

The NPI number for Jin Woo Park is 1548018609. It was assigned to this individual provider in the NPPES registry on May 13, 2024.

Where is Jin Woo Park located?

Jin Woo Park practices at 2017 S. Jefferson St. 1st Floor, Roanoke, VA 24014. The listed phone number is (540) 981-8025.

What is Jin Woo 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 Jin Woo Park enrolled in Medicare?

Yes. Jin Woo Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jin Woo Park was last updated on July 26, 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.