Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heysook Park Wanta

Individual provider Gastroenterology Physician · NPI 1164964680

Heysook Park Wanta is a Nurse Practitioner in New York, New York. Qualified in 2014, 12 years ago. Practices with Weill Medical College of Cornell, a 2,031-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2016
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1315 York Ave
New York, NY 10021-5304
Phone: (212) 746-5077
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence F339118 (NY)

Record details

NPI number1164964680
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 15, 2016
Last updated in NPPESOctober 14, 2021
Certification dateJune 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Weill Medical College Of Cornell — 2031 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in New York