JESSE K. PARK MD SC
NPI 1942482278
Clinic/Center - Primary Care in Burr Ridge, IL
About Jesse K. Park Md Sc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSE K. PARK MD SC (NPI 1942482278) is a healthcare organization registered as a primary care in Burr Ridge, Illinois and active in the NPI registry since November 2007. The organization lists Jesse Kitai Park, Medical Doctor, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jesse K. Park Md Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jesse K. Park MD Sc, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jesse K. Park MD Sc's NPI number?
The NPI number for Jesse K. Park MD Sc is 1942482278. It was assigned to this organization in the NPPES registry on November 28, 2007.
Where is Jesse K. Park MD Sc located?
Jesse K. Park MD Sc is located at 100 Tower Dr Suite 105, Burr Ridge, IL 60527. The listed phone number is (630) 325-8681.
What is Jesse K. Park MD Sc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Jesse K. Park MD Sc enrolled in Medicare?
Yes. Jesse K. Park MD Sc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Jesse K. Park MD Sc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Jesse K. Park MD Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Jesse K. Park MD Sc was last updated on February 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.
# Jesse K. Park Md Sc · NPI 1942482278
Primary Care organization in Burr Ridge, Illinois. Organization record, active in the CMS NPPES registry since November 28, 2007.
## Identity
- **NPI:** 1942482278 (Entity type: Organization)
- **Enumerated:** November 28, 2007
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jesse Park, MEDICAL DOCTOR
## Practice location
- **Address:** 100 TOWER DR, SUITE 105, Burr Ridge, IL 60527-5777
- **Phone:** (630) 325-8681 · **Fax:** (630) 325-3936
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2013
- **Other identifiers:** Medicare PIN K24386 (IL); Medicare UPIN F57281 (IL); Medicare PIN 212867 (IL); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1942482278) · Data from the CMS NPPES public registry.