SUNG JAE PARK (M.D.) – Family Medicine Physician, NPI 1336116201
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
2,861 FAMILY PRACTICE in IN
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Provider Addresses for SUNG JAE PARK (M.D.)
2235, East Dubois Drive, Warsaw, Kosciusko County, Indiana, 46580, United States
WARSAW, IN 465803212
Phone: (574) 267-8189
Fax: (574) 267-7554
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)
CMS reports 14 Open Payments records for all available years, with a total value of $261.
Total Amount is formed as General ($261) + Research ($0) + Ownership ($0) = $261.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Novo Nordisk Inc ($93).
Total Amount
$261
General + Research + Ownership
Payments
14
Total payment records
General Amount
$261
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $93 |
| PFIZER INC. | $37 |
| Inspire Medical Systems, Inc. | $27 |
| Axsome Therapeutics, Inc. | $25 |
| Janssen Pharmaceuticals, Inc | $21 |
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: 2009-10-14
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 |
|---|---|---|---|---|
| I20091014000810 | I | Family Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 552 | 202 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 298 | 128 | $0 |
| 83036 | Hemoglobin a1c level | 126 | 82 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 126 | 126 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 68 | 58 | $0 |
Insurance plans in this area (ZIP 46580)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| General Surgery | KS | |
| Certified Nurse Midwife (Cnm) | IN | |
| - | IN | |
| Family Practice | IN | |
| - | IN | |
| - | IN |
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