Jenny Rose Park, MD, MCR
NPI 1811725385ActiveIndividual· Student in an Organized Health Care Education/Training Program· Baraboo, WI
Student in an Organized Health Care Education/Training Program (MD, MCR) in Baraboo, Wisconsin, with an NPI issued in July 2024. Enrolled in Medicare as order and referring only - family practice.
Overview
| NPI | 1811725385 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD, MCR |
| Sole proprietor | No |
| NPI issued | Jul 25, 2024 |
| Last updated in NPPES | Apr 24, 2025 |
| Certified by provider | Apr 23, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Family Practice (WI) |
|---|
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