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

Jin S Park, MD

Individual provider Cardiovascular Disease Physician · NPI 1164400768

Jin S Park, MD is a Cardiovascular Disease (Cardiology) in Kansas City, Missouri. Graduated from State University of Ny Upstate Medical University in 1992, 34 years ago. Practices with Prime Healthcare Kansas City - Physician Services LLC, a 71-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Kansas, Missouri and New York.

Years since qualifying
34
Trained at
State University of Ny Upstate Medical University
Licensed in
KS, MO, NY
In the registry since
2006
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1000 Carondelet Dr Ste 201B
Kansas City, MO 64114
Phone: (913) 956-2250
Fax: (913) 956-2251
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 5721 W 119th St, Overland Park, KS 66209-3722 — (913) 498-6000
  • 201 Nw Rd Mize Rd, Blue Springs, MO 64014 — (816) 228-5900
  • 615 W Nursery St, Butler, MO 64730-1840 — (660) 200-7000
  • 7201 E 147th St Ste 120, Grandview, MO 64030-4204 — (913) 956-2250

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 20080015782 (MO)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 0433150 (KS)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 2008015782 (MO)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 194765 (NY)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2008015782 (MO)

Record details

NPI number1164400768
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 4, 2006
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

Medicare enrollment

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

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Also practisesINTERNAL MEDICINE
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 1992 (34 years in practice)
Group practice Prime Healthcare Kansas City - Physician Services Llc — 71 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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