JU AE PARK MD
NPI 1740743244
Student in an Organized Health Care Education/Training Program in Falls Church, VA

Q: What is Ju Ae Park's NPI number?

The NPI number for Ju Ae Park is 1740743244. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Q: What is Ju Ae Park's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ju Ae Park was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 April 11, 2019PECOS Enrolled

3300 GALLOWS RD, FALLS CHURCH, VA 22042(703) 776-4001 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 8, 2025, Apr 11, 2019 (2 updates tracked since 2019).

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About Ju Ae Park Md NPPES

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

JU AE PARK MD (NPI 1740743244) is an individual student in an organized health care education/training program in Falls Church, Virginia, licensed in New Jersey (25MA12622200) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Newark.

NPPES Registry Identity

NPI1740743244

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJU AE PARKCredential: MD

Location Address3300 GALLOWS RDFalls Church, VA 22042-3307

Mailing Address201 Lyons Ave # 3Newark, NJ 07112-2027

Phone(703) 776-4001

Sole ProprietorYes

Enumeration DateApril 11, 2019

Last NPPES UpdateApril 8, 20252 updates tracked since enumeration

NPPES CertifiedApril 8, 2025

✔ NPI 1740743244 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 NJ · 25MA12622200

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.

3300 GALLOWS RD, Falls Church, VA 22042

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Secondary Practice Location 1

Location 1201 Lyons Ave # 3Newark, NJ 07112-2027 · Phone (973) 926-7529

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ju Ae Park Md 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.

ALLISON ELIZABETH TWEEDIE MD

Psychiatry & Neurology (Psychiatry)