JOANNE HYEWON PARK – Physician Assistant, NPI 1912684440

JOANNE HYEWON PARK is a healthcare provider. based in Fullerton, California. specializing in PHYSICIAN ASSISTANT. The NPI Number for JOANNE HYEWON PARK is 1912684440

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
JOANNE HYEWON PARK
NPI
1912684440
Phone
(714) 992-7808
Address
2575 YORBA LINDA BLVD
Enumeration Date
27 June 2023
Last Update Date
18 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3107101919
Graduation Year
2024 (2 years ago)
PAC ID
4385165505
Group Practice PAC ID
0244570141
Professional Enrollment ID
I20250304003518
Address ID
CA904034809SA2811XBLVD301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

10,686 PHYSICIAN ASSISTANT in CA

Provider Addresses for JOANNE HYEWON PARK

  • 2575 YORBA LINDA BLVD

    FULLERTON, CA 928311615

    Phone: (714) 992-7808

    Mailing address matches the actual address.

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: 2025-03-04

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250304003518IPhysician AssistantCATBD

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.

Verify on CMS Revalidation Lookup Tool

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 92831)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244570141View full group profile
NameSpecialtyState
N E U R O S U R G E R YNV
Physician AssistantCA
Physician AssistantUT
N E U R O S U R G E R YCA
N E U R O S U R G E R YCA

Reviews

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Frequently asked questions

Can I verify JOANNE HYEWON PARK with an NPI only?
You can start verification with NPI 1912684440 for JOANNE HYEWON PARK, then check state licensing separately.
Does the file indicate JOANNE HYEWON PARK is practicing under active NPI?
Directory data currently reports JOANNE HYEWON PARK as active.
What is JOANNE HYEWON PARK best known for clinically?
Directory data describes JOANNE HYEWON PARK with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for JOANNE HYEWON PARK?
JOANNE HYEWON PARK's geographic hint is Fullerton, California in our summary view.
Is the information about JOANNE HYEWON PARK up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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