Ji Yeon Park, DO - Medicare Internal Medicine in Colton, CA

Ji Yeon Park, DO is a medicare enrolled "Internal Medicine" physician in Colton, California. She graduated from medical school in 2016 and has 8 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Providence Medical Foundation and her current practice location is 400 N Pepper Ave, Colton, California. You can reach out to her office (for appointments etc.) via phone at (909) 580-6266.

Ji Yeon Park is licensed to practice in California (license number 20A16572) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1295189850.

Contact Information

Ji Yeon Park, DO
400 N Pepper Ave,
Colton, CA 92324-1801
(909) 580-6266
Not Available

Map and Direction




Physician's Profile

Full NameJi Yeon Park
GenderFemale
SpecialityInternal Medicine
Experience8 Years
Location400 N Pepper Ave, Colton, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ji Yeon Park graduated from medical school in 2016
  NPI Data:
  • NPI Number: 1295189850
  • Provider Enumeration Date: 04/20/2016
  • Last Update Date: 12/10/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0244562213
  • Enrollment ID: I20191023002651

Medical Identifiers

Medical identifiers for Ji Yeon Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295189850NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 20A16572 (California)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Joseph HospitalOrange, CAHospital
St Jude Medical CenterFullerton, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Medical Foundation89219932051312

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ji Yeon Park allows following entities to bill medicare on her behalf.
Entity NameProvidence Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285890624
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346
Entity NameQuantum Healthcare Medical Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568490597
PECOS PAC ID: 5294647574
Enrollment ID: O20040924000422
Entity NameClinic Services Of California Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1578958450
PECOS PAC ID: 7810209715
Enrollment ID: O20150707001394

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ji Yeon Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ji Yeon Park, DO
400 N Pepper Ave,
Colton, CA 92324-1801

Ph: () -
Ji Yeon Park, DO
400 N Pepper Ave,
Colton, CA 92324-1801

Ph: (909) 580-6266

Reviews and Comments


Internal Medicine Doctors in Colton, CA

Dr. Curtis Daniel Converse, D.O.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-580-1000    
Gilbert Chen, MD
Internal Medicine
Medicare: Medicare Enrolled
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-580-6343    
Dr. Roy Chi Wing Lung, MD
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-580-1000    
Neeka Shayan,
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 400 N Pepper Ave Ste 204, Colton, CA 92324
Phone: 909-580-6266    
Dr. Molood Hadi, DO
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-580-1000    
Dr. Sunil Kumar Nowrangi, MD
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-580-6275    Fax: 909-580-6275
Joji James, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 400 N Pepper Ave, Colton, CA 92324
Phone: 909-835-7496    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.