DR. SUSAN JIN-SUN PARK (MD) – Family Medicine Physician, NPI 1003070640

DR. SUSAN JIN-SUN PARK (MD) is a healthcare provider. based in Reno, Nevada. specializing in FAMILY PRACTICE, SPORTS MEDICINE. They hold the professional credentials MD. They hold a License No. 13322 (NV). The NPI Number for DR. SUSAN JIN-SUN PARK (MD) is 1003070640

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
DR. SUSAN JIN-SUN PARK (MD)
NPI
1003070640
Phone
(775) 982-5262
Address
850 HARVARD WAY
Enumeration Date
14 July 2008
Last Update Date
21 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Secondary Phone
7759828255
Graduation Year
2005 (21 years ago)
PAC ID
9133282668
Group Practice PAC ID
0244139798
Professional Enrollment ID
I20100420000876
Address ID
NV895112060RE661XXDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:17State licenses:2Digital endpointsOther names

992 FAMILY PRACTICE in NV

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Provider Addresses for DR. SUSAN JIN-SUN PARK (MD)

  • 850, Harvard Way, Reno, Washoe County, Nevada, 89502, United States

    RENO, NV 895022055

    Phone: (775) 982-5262

    Fax: (775) 982-4595

    Type: Mailing

  • 1155 MILL ST # MCM14

    RENO, NV 895021576

    Phone: (775) 982-5262

    Fax: (775) 982-3900

    Type: Mailing

  • 661, Sierra Rose Drive, Reno, Washoe County, Nevada, 89511, United States

    RENO, NV 89511

    Phone: (775) 982-8255

    Fax: (775) 982-8251

    Type: Location

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: 2010-04-20

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
I20100420000876IFamily PracticeNVTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes438168$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit4646$0
99213Established patient office or other outpatient visit, 20-29 minutes4134$0
G0008Administration of influenza virus vaccine2727$0
90662Influenza vaccine split virus, preservative free2727$0
View full utilization report →

Insurance plans in this area (ZIP 89502)

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Provider's Procedures

DR. SUSAN JIN-SUN PARK (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINENV83036Hemoglobin A1C level1814

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: 0244139798View full group profile
NameSpecialtyState
Family PracticeNV
Internal MedicineNV
Physician AssistantNV
Family PracticeNV
-NV
Physician AssistantNV
Nurse PractitionerNV
-NV
Nurse PractitionerNV
Physician AssistantNV

Reviews

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Frequently asked questions

Can I use this page to confirm DR. SUSAN JIN-SUN PARK (MD)'s NPI?
Yes. DR. SUSAN JIN-SUN PARK (MD) is listed with NPI 1003070640 in the public NPI dataset.
Is DR. SUSAN JIN-SUN PARK (MD) listed as active for patients and plans?
The listing shows DR. SUSAN JIN-SUN PARK (MD) as active in the NPI system.
What healthcare role does DR. SUSAN JIN-SUN PARK (MD) hold?
Scheduling teams often label DR. SUSAN JIN-SUN PARK (MD) under Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is DR. SUSAN JIN-SUN PARK (MD) based?
DR. SUSAN JIN-SUN PARK (MD) is tied to Reno, Nevada in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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