Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JIWON PARK MD
NPI 1841970902
Student in an Organized Health Care Education/Training Program in Hallandale Beach, FL

Q: What is Jiwon Park's NPI number?

The NPI number for Jiwon Park is 1841970902. It was assigned to this individual provider in the NPPES registry on July 24, 2023.

Q: What is Jiwon 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 Jiwon Park was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 37 days 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 July 24, 2023PECOS Enrolled

410 E HALLANDALE BEACH BLVD, HALLANDALE BEACH, FL 33009(954) 454-5777 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 16, 2026, Jul 24, 2023 (2 updates tracked since 2023).

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About Jiwon Park Md NPPES

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

JIWON PARK MD (NPI 1841970902) is an individual student in an organized health care education/training program in Hallandale Beach, Florida and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841970902

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJIWON PARKCredential: MD

Location Address410 E HALLANDALE BEACH BLVDHallandale Beach, FL 33009-5529

Mailing Address234 E 149th St Fl 8Bronx, NY 10451-5504 · (646) 954-9970

Phone(954) 454-5777

Sole ProprietorNo

Enumeration DateJuly 24, 2023

Last NPPES UpdateJuly 16, 20262 updates tracked since enumeration

NPPES CertifiedJuly 16, 2026

✔ NPI 1841970902 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.

410 E HALLANDALE BEACH BLVD, Hallandale Beach, FL 33009

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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)

Jiwon 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 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHARINA CASTRO MD

Internal Medicine