Kwang Jin Park, NP - Medicare Nurse Practitioner in Orlando, FL

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Kwang Jin Park, NP is a medicare enrolled "Nurse Practitioner - Adult Health" in Orlando, Florida. His current practice location is 9400 Turkey Lake Rd, Orlando, Florida. You can reach out to his office (for appointments etc.) via phone at (407) 351-8500.

Kwang Jin Park is licensed to practice in Florida (license number APRN11017162) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720749278.

Contact Information

Kwang Jin Park, NP
9400 Turkey Lake Rd,
Orlando, FL 32819-8001
(407) 351-8500
(407) 345-9765

Map and Direction




Provider's Profile

Full NameKwang Jin Park
GenderMale
SpecialityNurse Practitioner - Adult Health
Location9400 Turkey Lake Rd, Orlando, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1720749278
  • Provider Enumeration Date: 01/06/2022
  • Last Update Date: 10/24/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9739568122
  • Enrollment ID: I20220615000476

Medical Identifiers

Medical identifiers for Kwang Jin Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720749278NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 11017162 (Florida)Secondary
363LA2200XNurse Practitioner - Adult Health APRN11017162 (Florida)Primary

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. Kwang Jin Park allows following entities to bill medicare on his behalf.
Entity NameOrlando Health Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669429577
PECOS PAC ID: 9537059084
Enrollment ID: O20040318000044
Entity NameFlorida Nephrology Plc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265747828
PECOS PAC ID: 3971772062
Enrollment ID: O20110805000550

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. Kwang Jin 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
Kwang Jin Park, NP
7350 Futures Dr Ste 1,
Orlando, FL 32819-9082

Ph: (321) 214-0028		Kwang Jin Park, NP
9400 Turkey Lake Rd,
Orlando, FL 32819-8001

Ph: (407) 351-8500

Reviews and Comments


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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.