DR. JOHN MOONKEUN PARK MD NPI 1023394665

NPI Information

  • NPI: 1023394665
  • Provider Name: DR. JOHN MOONKEUN PARK, MD
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 17404 BURKE ST STE 102
    OMAHA, NE
    ZIP 68118
  • Phone: (531) 466-4260

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NPI Details

DR. John Moonkeun Park, MD is a vascular surgery surgery in Omaha, NE with 21 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. John Moonkeun Park, MD NPI is 1023394665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Graduation Year:2005

The provider's business location address is:

17404 BURKE ST STE 102
OMAHA, NE
ZIP 68118-242
Phone: (531) 466-4260

The NPI 1023394665 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • Ultrasonic guidance for blood vessel access (HCPCS:76937)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • Follow-up hospital inpatient care per day, typically 15 minutes (HCPCS:99231)
  • Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts (HCPCS:93978)
  • Ultrasound of hemodialysis access (HCPCS:93990)
  • Complete ultrasound study of arm and leg arteries (HCPCS:93923)
  • Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts (HCPCS:93978)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Initial hospital inpatient care per day, typically 50 minutes (HCPCS:99222)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Review by radiologist of abdominal aorta image (HCPCS:75625)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Initial hospital inpatient care per day, typically 30 minutes (HCPCS:99221)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Review by radiologist of both arms or legs arteries image (HCPCS:75716)
  • Insertion of stent and blood clot protection device in neck artery with review by radiologist (HCPCS:37215)
  • Measurement of brain wave activity (eeg) outside the brain during surgery (HCPCS:95955)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Complete ultrasound of abdomen and pelvis artery and vein blood flow (HCPCS:93975)
  • Review by radiologist of arm or leg artery image (HCPCS:75710)
  • Insertion of tunneled central venous tube for infusion (5 years or older) (HCPCS:36558)
  • Insertion of vena cava filter with review by radiologist (HCPCS:37191)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Varicose vein removal (HCPCS:NAN08)
  • Leg revascularization (restoring blood flow) (HCPCS:NAN01)

The enumeration date for this NPI number is 10/27/2011 and was last updated on 9/23/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular Surgery35.095909OHIONo
2208600000XSurgery35.095909OHIONo
32086S0129XSurgeryVascular Surgery26509NEBRASKAYes
42086S0129XSurgeryVascular Surgery40563IOWANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110025724800MEDICAIDNEBRASKA
210026135100MEDICAIDNEBRASKA
31023394665MEDICAIDIOWA
447068731713MEDICAIDNEBRASKA
510026454700MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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