JEONG MI PAK (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174097331
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,191 NURSE PRACTITIONER in CT
Provider Addresses for JEONG MI PAK (APRN)
574 Willis St
Bristol, CT 060107267
Phone: (866) 333-9758
Type: Location
Manchester Memorial Hospital, 71, Haynes Street, Manchester, Hartford County, Connecticut, 06040, United States
MANCHESTER, CT 060404188
Phone: (860) 646-1222
Type: Mailing
11-13 SUNFLOWER AVE
PARAMUS, NJ 076523700
Phone: (855) 505-2880
Type: Location
574 WILLIS ST
BRISTOL, CT 060107267
Phone: (866) 333-9758
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $37.
Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.
Last reported payment date: 2024-01-18 • Largest payer in this snapshot: Neurocrine BioSciences Inc. ($24).
Total Amount
$37
General + Research + Ownership
Payments
2
Total payment records
General Amount
$37
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Neurocrine BioSciences Inc. | $24 |
| Corium, LLC | $13 |
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: 2023-05-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20201201000118 | I | Nurse Practitioner | CT | TBD |
| I20220621003167 | I | Nurse Practitioner | FL | TBD |
| I20230501000597 | I | Nurse Practitioner | NJ | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 816 | 204 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 739 | 214 | $0 |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 279 | 112 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 90 | 90 | $0 |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 48 | 48 | $0 |
Insurance plans in this area (ZIP 06010)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CT | |
| Nurse Practitioner | CT | |
| - | CT | |
| - | CT | |
| Clinical Psychologist | NY | |
| - | CT | |
| Clinical Social Worker | CT | |
| Nurse Practitioner | CT | |
| Clinical Social Worker | CT | |
| Nurse Practitioner | CT |
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