CHAN JEROME PARK (MD, PHD) – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1932498722
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
118 THORACIC SURGERY in WI
Provider Addresses for CHAN JEROME PARK (MD, PHD)
2237 KEYSTONE CIR
ANDOVER, KS 670028742
Phone: (316) 616-6272
Fax: (316) 616-0407
Type: Mailing
600 HIGHLAND AVE
MADISON, WI 537920001
Phone: (608) 263-6400
Type: Location
PO BOX 33269
PHOENIX, AZ 850673269
Phone: (602) 406-4786
Fax: (916) 636-4358
Type: Mailing
7190 S CIMARRON RD
LAS VEGAS, NV 891132171
Phone: (702) 675-3240
Fax: (702) 982-6347
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $16,631.
Total Amount is formed as General ($16,631) + Research ($0) + Ownership ($0) = $16,631.
Last reported payment date: 2024-10-28 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($12,244).
Total Amount
$16,631
General + Research + Ownership
Payments
77
Total payment records
General Amount
$16,631
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $12,244 |
| Medtronic, Inc. | $1,294 |
| ABIOMED | $822 |
| Zimmer Biomet Holdings, Inc. | $793 |
| ATRICURE, INC. | $653 |
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: 2021-05-25
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 |
|---|---|---|---|---|
| I20210525000936 | I | Thoracic Surgery | NV | 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 |
|---|---|---|---|---|
| 99205 | New patient office or other outpatient visit, 60-74 minutes | 37 | 37 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 37 | 36 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 35 | 34 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 28 | 28 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 25 | 22 | $0 |
Insurance plans in this area (ZIP 67002)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | NV | |
| Internal Medicine | NV | |
| Infectious Disease | NY | |
| Family Practice | NY | |
| Internal Medicine | NV | |
| Internal Medicine | NV | |
| Critical Care (Intensivists), Pulmonary Disease | AZ | |
| Nurse Practitioner | NV | |
| Internal Medicine, Hospitalist | NV | |
| Hospitalist, Internal Medicine | NV |
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