DERIC MINWOO PARK MD
NPI 1730391509
Psychiatry & Neurology - Diagnostic Neuroimaging in Chicago, IL

Q: What is Deric Park's NPI number?

The NPI number for Deric Park is 1730391509. It was assigned to this individual provider in the NPPES registry on May 4, 2007.

Q: What is Deric Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Diagnostic Neuroimaging, with taxonomy code 2084D0003X.

Q: When was this NPI record last updated?

The NPPES record for Deric Park was last updated on September 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.

Active since May 04, 2007PECOS EnrolledAccepts Medicare Assignment

83.48/100

CMS Quality Rating

5841 S MARYLAND AVE # MC2030, CHICAGO, IL 60637(773) 702-1061 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 17, 2024, Feb 6, 2019 (2 updates tracked since 2019).

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About Deric Minwoo Park Md NPPES

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

DERIC MINWOO PARK MD (NPI 1730391509) is an individual diagnostic neuroimaging provider in Chicago, Illinois, licensed in New Jersey (25MA11934400) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and is a graduate of Loma Linda University School Of Medicine (1996).

NPPES Registry Identity

NPI1730391509

Entity TypeIndividualMale

Primary Taxonomy2084D0003X

Provider Legal NameDERIC MINWOO PARKCredential: MD

Location Address5841 S MARYLAND AVE # MC2030Chicago, IL 60637-1443

Mailing Address150 Harvester Dr Ste 300Burr Ridge, IL 60527-5965 · (773) 702-1061

Phone(773) 702-1061

Sole ProprietorNo

Medical School CMSLoma Linda University School Of MedicineGraduated 1996

Enumeration DateMay 4, 2007

Last NPPES UpdateSeptember 17, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2024

✔ NPI 1730391509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Diagnostic NeuroimagingAllopathic & Osteopathic Physicians

Taxonomy Code2084D0003X

Licenses✔ Licensed in NJ · 25MA11934400✔ Licensed in PA · MD431575

Definition

A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards of performance and interpretation of Magnetic Resonance Imaging (MRI / MRA) of the head, spine, and peripheral nerves, and Computed Tomography (CT) of the head and spine. Physicians are trained in the administration of contrast media and the recognition and treatment of adverse reactions to contrast media. Neuroimaging training encompasses thorough knowledge of clinical neurology, neurophysiology, neuroanatomy, neurochemistry, neuropharmacology, and dynamics of cerebrospinal fluid circulation. Physicians possess special expertise in the technical aspects and clinical applications of each of the modalities and techniques of neuroimaging.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 0101247111 (VA), 036147170 (IL)

5841 S MARYLAND AVE # MC2030, Chicago, IL 60637

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Deric Minwoo Park Md 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 ID8729186614

PECOS Enrollment IDI20230830000956

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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

193 services70 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

78 services65 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

46 services46 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

45 services36 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.48/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

77.91

Promoting Interoperability

100

Improvement Activities

Cost

54.97

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Temozolomide, oral, 5 mg J8700

Treatment-Treatment - Miscellaneous · category RX000N

3 suppliers17 claims3,785 services$0.42 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

3 suppliers14 claims26 services$12.61 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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