DA YON PARK (PA-C) – Physician Assistant, NPI 1053883579

DA YON PARK (PA-C) is a healthcare provider. based in Fairfax, Virginia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 0110006433 (VA). The NPI Number for DA YON PARK (PA-C) is 1053883579

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DA YON PARK (PA-C)
NPI
1053883579
Phone
(703) 391-0111
Address
3620 JOSEPH SIEWICK DR STE 201
Enumeration Date
21 December 2018
Last Update Date
21 December 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7035910077
Graduation Year
2018 (8 years ago)
PAC ID
2163769936
Group Practice PAC ID
8921492083
Professional Enrollment ID
I20190201000510
Address ID
VA220332907FA3998XDRXX403
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

4,429 PHYSICIAN ASSISTANT in VA

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Provider Addresses for DA YON PARK (PA-C)

  • Joseph Siewick Drive, Chantilly, Fairfax County, Virginia, 22033, United States

    FAIRFAX, VA 220331758

    Phone: (703) 391-0111

    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: 2019-02-01

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
I20190201000510IPhysician AssistantDCTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes247174$0
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg154104$0
20550Injection into tendon or ligament13084$0
99203New patient office or other outpatient visit, 30-44 minutes127127$0
76942Ultrasonic guidance for needle placement11884$0
View full utilization report →

Insurance plans in this area (ZIP 22033)

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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: 8921492083View full group profile
NameSpecialtyState
Orthopedic SurgeryVA

Reviews

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Frequently asked questions

What federal number belongs to DA YON PARK (PA-C)?
The federal identifier for DA YON PARK (PA-C) is NPI 1053883579.
Is DA YON PARK (PA-C) currently active in the NPI registry?
CMS-published data lists DA YON PARK (PA-C) as an active registrant.
Does DA YON PARK (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for DA YON PARK (PA-C). Clinical services aligned with this taxonomy classification.
What location shows for DA YON PARK (PA-C)?
We surface Fairfax, Virginia for DA YON PARK (PA-C) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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