DR. CHAN JEROME PARK (NPI# 1932498722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932498722 |
| Entity Type | Individual |
| Full Name | DR. CHAN JEROME PARK |
| Credential | MD, PHD |
| Practice Address |
600 Highland Ave Madison WI 53792-0001 |
| Mailing Address |
2237 Keystone Cir Andover KS 67002-8742 |
| Practice Telephone | 6082636400 |
| Mailing Telephone | 3166166272 |
| Mailing Fax Number | 3166160407 |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 65771 | WI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828963 | Chan Ho Park | Physician Assistant | 4721 Oakwood Ave, Los Angeles, CA 90004-3112 | 2020-10-14 |
| 1508404492 | Chan Jin Park | Acupuncturist | 21537 48th Ave Apt 2b, Bayside, NY 11364-1359 | 2019-12-11 |
| 1700147378 | Chan H Park | Internal Medicine | 22226 Cliff Ave S, #304, Des Moines, WA 98198-4619 | 2012-05-30 |
| 1760644280 | Chan Woo Park | Otolaryngology | 90 Bergen Street- Suite 8100, Department of Otolaryngology, Doc Building, Newark, NJ 07103 | 2008-06-26 |
| 1700092103 | Chan Hoon Park | Family Medicine | 905 Victory Hwy, Slatersville, RI 02876 | 2007-05-15 |
| 1871617027 | Chan M Park | Dentist | 111 Deerwood Rd Ste 130, San Ramon, CA 94583-2194 | 2007-03-16 |
| 1457467037 | Chan M Park | Family Medicine | 6460 Greensboro Rd, Ridgeway, VA 24148-3478 | 2006-08-23 |
| 1619940681 | Chan S. Park | Emergency Medicine | Michumi, Pllc Dba Med Express of Williamsburg, Va, 120 Monticello Ave, Williamsburg, VA 23185 | 2006-02-09 |
| 1255336665 | Chan H. Park | Family Medicine | 9500 Stockdale Hwy, Suite 203, Bakersfield, CA 93311-3620 | 2005-06-14 |
| 1366071045 | Chan Young Park | Student in an Organized Health Care Education/Training Program | 11301 Wilshire Blvd Bldg 500, Los Angeles, CA 90073-1003 | 2020-04-05 |
| Street Address |
600 HIGHLAND AVE |
| City | MADISON |
| State | WI |
| Zip Code | 53792-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336141530 | Michael A Porte | Pediatrics | 600 Highland Ave, Madison, WI 53792-0001 | 2005-06-01 |
| 1922606433 | Catherine Harnois | Radiology | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-16 |
| 1265039812 | Sara Brown | Nurse Practitioner | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-07 |
| 1063019602 | Angela Filauro Schroeder | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-10-06 |
| 1134736556 | Kelly A Kopecki | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-29 |
| 1699382051 | Megan Elizabeth Grassl | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-29 |
| 1568079234 | Michelle Catherine Sawaya | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-28 |
| 1417564113 | Megan Severa | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-26 |
| 1275140055 | Danielle Knox Alexander | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-25 |
| 1427665397 | Kristan O'toole | Dietitian, Registered | 600 Highland Ave, Madison, WI 53792-0001 | 2020-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902416969 | Cynthia Iradukunda | Student in an Organized Health Care Education/Training Program | University of Wisconsin School of Medicine and Public H, 600 Highland Ave, B6/319, Madison, WI 53792 | 2020-08-05 |
| 1689162661 | Tseun Han James Kong | Psychiatry & Neurology | Uw Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792 | 2018-04-25 |
| 1194248013 | Kyle Erick Rudningen | Dermatology | Uw Hosptials & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-07-23 |
| 1477083194 | Maxwell Joseph Wingelaar | Ophthalmology | Uw Health University Hospital, Madison, WI 53792 | 2017-06-14 |
| 1790212603 | Imad Khan | Psychiatry & Neurology | Uw Hospitals & Clinics 600 Highland Avenue, Madison, WI 53792 | 2017-05-23 |
| 1700334745 | Krista Lee Rieger | Pharmacist | 600 Higland Avenue, University of Wisconsin Hospital and Clinics, Madison, WI 53792 | 2016-09-20 |
| 1780070086 | Christina Amend | Pediatrics | American Family Childrens Hospital 600 Highland Ave, Madison, WI 53792 | 2015-04-13 |
| 1487040127 | Michelle Stoffel | Pathology | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792 | 2015-04-09 |
| 1417363888 | Jenna Bender | Pharmacist | 600 Highland Avenue, 1530, University of Wisconsin Hospital and Clinics, Madison, WI 53792 | 2014-07-07 |
| 1841619889 | Ying Wang | Psychiatry & Neurology | 600 Highland Ave,h4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2014-04-07 |
| Find all providers in zip 53792 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972730745 | Robert Cesar Gomez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 63 Cambridge Rd, Madison, WI 53704-5961 | 2009-06-18 |
| 1407072747 | Robert P. N. Shearin | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 308 Hillchase Dr, Madison, MS 39110-8841 | 2007-04-17 |
| 1164510871 | George R. Reiss IIi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 S. Park St, Madison, WI 53715-1830 | 2006-10-10 |
| 1316381106 | Erik Ellingson Lewis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792-0001 | 2013-04-23 |
| 1609142470 | Swaroop Bommareddi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792-6410 | 2012-03-27 |
| 1528294329 | Ghulam Murtaza | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 S Park St, Madison, WI 53715-1830 | 2009-06-08 |
| 1184635096 | Deemy Rekkas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792 | 2006-08-10 |
| 1114971439 | Mario G Gasparri | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792 | 2006-05-20 |
| 1760434443 | Alfred C Nicolosi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 S Park St, Madison, WI 53715-1830 | 2006-05-17 |
| 1912957564 | Teruya Nakamura | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 600 Highland Ave, Madison, WI 53792-0001 | 2006-05-12 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.