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DR. JENNY ROSE PARK MD, MCR
NPI 1811725385
Student in an Organized Health Care Education/Training Program in Baraboo, WI

Active since July 25, 2024PECOS Enrolled
1700 TUTTLE ST, BARABOO, WI 53913(608) 355-3800(380) 355-7007 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jenny Rose Park Md, Mcr NPPES

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

DR. JENNY ROSE PARK MD, MCR (NPI 1811725385) is an individual student in an organized health care education/training program in Baraboo, Wisconsin and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1811725385
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. JENNY ROSE PARKCredential: MD, MCR
Location Address1700 TUTTLE STBaraboo, WI 53913-3319
Mailing Address1100 Delaplaine CtMadison, WI 53715-1840 · (608) 263-4550
Phone(608) 355-3800
Fax(380) 355-7007
Sole ProprietorNo
Enumeration DateJuly 25, 2024
Last NPPES UpdateApril 24, 2025
NPPES CertifiedApril 23, 2025
✔ NPI 1811725385 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.
1700 TUTTLE ST, Baraboo, WI 53913
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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)

Dr. Jenny Rose Park Md, Mcr 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.

AME FISCHER CNM
Advanced Practice Midwife
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
CHERYL R GOECKERMANN MD
Internal Medicine (Addiction Medicine)
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
EMILY CATHERINE HORN DO
Student in an Organized Health Care Education/Training Program
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
FAYE J BRICKL
Pharmacist
1700 TUTTLE ST, SUITE 300
BARABOO, WI 53913
Sauk County (608) 356-6966
DR. SARANAH LINSCOTT DO
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
STUART G HANNAH MD
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
ANNA BADTKE PA-C
Physician Assistant
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800
RANDY J KRSZJZANIEK MD
Family Medicine
1700 TUTTLE ST
BARABOO, WI 53913
Sauk County (608) 355-3800

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 Jenny Park's NPI number?

The NPI number for Jenny Park is 1811725385. It was assigned to this individual provider in the NPPES registry on July 25, 2024.

Where is Jenny Park located?

Jenny Park practices at 1700 Tuttle St, Baraboo, WI 53913. The listed phone number is (608) 355-3800.

What is Jenny 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 Jenny Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jenny Park was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.