PETER CHUNGHYUN PARK MD NPI 1508899915

NPI Information

NPI: 1508899915
Provider Name: PETER CHUNGHYUN PARK, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 580 COURT ST
KEENE, NH
ZIP 03431
Phone: (603) 354-5400

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NPI Details

Peter Chunghyun Park, MD is a family medicine in Keene, NH with 30 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Peter Chunghyun Park, MD NPI is 1508899915. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

580 COURT ST
KEENE, NH
ZIP 03431-718
Phone: (603) 354-5400

The NPI 1508899915 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)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 7/9/2006 and was last updated on 9/25/2023.

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	License Number	License State	Primary
1	207Q00000X	Family Medicine	2022-011755	NORTH CAROLINA	No
2	207Q00000X	Family Medicine	042-0009719	VERMONT	No
3	207Q00000X	Family Medicine	EL12775	NEW HAMPSHIRE	Yes

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
1	0VN1844	MEDICAID	VERMONT
2	2022-01755	OTHER	NORTH CAROLINA	NORTH CAROLINA MEDICAL LICENSE

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: 3/30/2025

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