DR. JIN HEWA PARK D.O.
NPI 1992800353
Family Medicine in Claremont, CA
About Dr. Jin Hewa Park D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JIN HEWA PARK D.O. (NPI 1992800353) is an individual family medicine provider in Claremont, California, licensed in California (20A6738) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Jin Hewa Park D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jin Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Chino Hills, CA 91709
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1770515280 (California)
- 5,228 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91711 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CLAREMONT, CA 91711
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 Jin Park's NPI number?
The NPI number for Jin Park is 1992800353. It was assigned to this individual provider in the NPPES registry on September 13, 2006. The provider is also known as Dr. Jin Wha Park Do.
Where is Jin Park located?
Jin Park practices at 250 W San Jose Ave, Claremont, CA 91711. The listed phone number is (909) 399-2063.
What is Jin Park's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Jin Park enrolled in Medicare?
Yes. Jin Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jin Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jin Park reassigns Medicare benefits to Southern California Permanente Medical Group (Chino Hills, CA). The 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 Jin Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jin Park was last updated on December 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Dr. Jin Hewa Park, D.O. · NPI 1992800353
Family Medicine physician in Claremont, California. Individual provider, active in the CMS NPPES registry since September 13, 2006.
## Identity
- **NPI:** 1992800353 (Entity type: Individual)
- **Enumerated:** September 13, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 20A6738 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 250 W SAN JOSE AVE, Claremont, CA 91711-5207
- **Phone:** (909) 399-2063
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1396287082, Chino Hills, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 23, 2021
- **Other identifiers:** Medicaid FHC11584G (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1992800353) · Data from the CMS NPPES public registry.