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YONGHO PARK
NPI 1770386443
Student in an Organized Health Care Education/Training Program in Worcester, MA

Active since March 28, 2025PECOS Enrolled
55 LAKE AVE N, WORCESTER, MA 01655(508) 334-1000 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Yongho Park NPPES

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

YONGHO PARK (NPI 1770386443) is an individual student in an organized health care education/training program in Worcester, Massachusetts and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770386443
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameYONGHO PARK
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing Address55 Lake Ave NWorcester, MA 01655-0002 · (508) 334-1000
Phone(508) 334-1000
Sole ProprietorNo
Enumeration DateMarch 28, 2025
NPPES CertifiedMarch 28, 2025
✔ NPI 1770386443 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.
55 LAKE AVE N, Worcester, MA 01655
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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)

Yongho 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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. SHERINE MARY HASSEY-HALLIGAN NP
Nurse Practitioner
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271

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 Yongho Park's NPI number?

The NPI number for Yongho Park is 1770386443. It was assigned to this individual provider in the NPPES registry on March 28, 2025.

Where is Yongho Park located?

Yongho Park practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-1000.

What is Yongho 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 Yongho Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Yongho Park was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.