JONGHWA PARK – Certified Registered Nurse Anesthetist, NPI 1013436187

JONGHWA PARK is a healthcare provider. based in Robbinsdale, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 1774380 (MN). The NPI Number for JONGHWA PARK is 1013436187

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
JONGHWA PARK
NPI
1013436187
Phone
(763) 581-3980
Address
3300 OAKDALE AVE N
Enumeration Date
11 September 2017
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
9522321110
Graduation Year
2017 (9 years ago)
PAC ID
4789940347
Group Practice PAC ID
5698689123
Professional Enrollment ID
I20171114003706
Address ID
MN553374480BU1000XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

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Provider Addresses for JONGHWA PARK

  • North Memorial Medical Center, 3300, Oakdale Avenue North, Robbinsdale, Hennepin County, Minnesota, 55422, United States

    ROBBINSDALE, MN 554222926

    Phone: (763) 581-3980

    Fax: (763) 581-3591

    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: 2017-11-14

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171114003706ICertified Registered Nurse Anesthetist (Crna)MNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1414$0
View full utilization report →

Insurance plans in this area (ZIP 55422)

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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: 5698689123View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
-MN
-MN
-MN
A N E S T H E S I O L O G YMN
A N E S T H E S I O L O G YMN
-MN

Reviews

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Frequently asked questions

Where can patients find JONGHWA PARK's NPI?
You can confirm JONGHWA PARK with NPI 1013436187; it appears in the national provider directory.
Is JONGHWA PARK currently active in the NPI registry?
CMS-published data lists JONGHWA PARK as an active registrant.
Does JONGHWA PARK list a primary specialty?
If you are matching referrals, note Certified Registered Nurse Anesthetist for JONGHWA PARK. Clinical services aligned with this taxonomy classification.
What location metadata exists for JONGHWA PARK?
The page summarizes Robbinsdale, Minnesota for JONGHWA PARK; expand the address list for detail.
Is JONGHWA PARK a real provider?
This page reflects official NPPES data for NPI 1013436187. Always confirm identity and privileges with the practice and licensing boards.

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