JOANN PARK (MD) – Child & Adolescent Psychiatry Physician, NPI 1316396906
Child & Adolescent Psychiatry Physician
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Profile Insights
NPPES metrics only — not quality of care.
4,134 PSYCHIATRY in CA
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Provider Addresses for JOANN PARK (MD)
2230, Stockton Boulevard, Sacramento, Sacramento County, California, 95817, United States
SACRAMENTO, CA 958171353
Phone: (916) 734-2614
Type: Location
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 462024164
Phone: (317) 944-8162
Type: Mailing
2230 Stockton Blvd
Sacramento, CA 958171353
Phone: (916) 734-2614
Type: Location
1462 CEDARBROOK RD
WEST SACRAMENTO, CA 956915084
Phone: (224) 577-5251
Fax: (916) 734-0849
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240725003006 | I | Psychiatry | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95817)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | IN | |
| A N E S T H E S I O L O G Y | IN | |
| A N E S T H E S I O L O G Y | OH | |
| Otolaryngology, Plastic And Reconstructive Surgery | IN | |
| A N E S T H E S I O L O G Y | KY | |
| Anesthesiology Assistant | IN | |
| Emergency Medicine, Pediatric Medicine | IN | |
| General Surgery | IN | |
| Neurology, Epileptologists | IN | |
| U R O L O G Y | OH |
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