SUNGJIN PARK – Physician Assistant, NPI 1730546078

SUNGJIN PARK is a healthcare provider. based in Dallas, Texas. specializing in PHYSICIAN ASSISTANT. They hold a License No. PATMP596408 (TX). The NPI Number for SUNGJIN PARK is 1730546078

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
SUNGJIN PARK
NPI
1730546078
Phone
(972) 884-4400
Address
10400 N CENTRAL EXPY
Enumeration Date
18 January 2016
Last Update Date
15 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9729194747
Graduation Year
2015 (11 years ago)
PAC ID
7113223785
Group Practice PAC ID
4183049315
Professional Enrollment ID
I20160308000795
Address ID
TX752312297DA10400EXPY400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:10State licenses:2Digital endpointsOther names

8,497 PHYSICIAN ASSISTANT in TX

Provider Addresses for SUNGJIN PARK

  • 10400, North Central Expressway, Gifford, Dallas, Dallas County, Texas, 75231, United States

    DALLAS, TX 752312297

    Phone: (972) 884-4400

    Fax: (972) 884-4401

    Type: Mailing

  • 729 W Bedford Euless Rd

    #206

    Hurst, TX 760533939

    Phone: (817) 288-0084

    Fax: (817) 445-1039

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $382.

Total Amount is formed as General ($382) + Research ($0) + Ownership ($0) = $382.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($154).

Total Amount

$382

General + Research + Ownership

Payments

20

Total payment records

General Amount

$382

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2016-03-08

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
I20160308000795IPhysician AssistantTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75231)

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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: 4183049315View full group profile
NameSpecialtyState
Hand SurgeryTX

Reviews

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Frequently asked questions

What unique ID ties claims to SUNGJIN PARK?
NPI 1730546078 is assigned to SUNGJIN PARK under the national enumeration system.
Is SUNGJIN PARK's NPI currently valid?
The extract we use shows SUNGJIN PARK as active.
What kind of provider is SUNGJIN PARK?
The page reflects Physician Assistant for SUNGJIN PARK. Clinical services aligned with this taxonomy classification.
Does SUNGJIN PARK practice in Texas?
You will see Dallas, Texas on file for SUNGJIN PARK alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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