Jay Y Park, M.D., P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD20395 Issued in OR

Practice address

360 S Garden Way Ste 230
Eugene, OR 97401-8187

Phone

(541) 747-6159

Fax

(541) 741-7249

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498
  NPD (past)
• Good Samaritan Hospital Corvallis

  • Durable Medical Equipment & Medical Supplies
  • Corvallis, OR
  • NPI 1477851186
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1023086857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 230",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018187",
            "telephone_number": "541-747-6159",
            "fax_number": "541-741-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 230",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018187",
            "telephone_number": "541-747-6159",
            "fax_number": "541-741-7249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAY",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD20395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071634",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yulia Papleka, LMT
• Richard Tan Lim Pardilla, M.D.
• Barbara Lynn Paris, MA
• Starla Kae Paris, BS
• Alayna L Park, PHD
• Jin Young Park, FNP-BC
• John J Park, D.D.S
• Junyoung Park
• Kayla Skye Park, RN
• Sangmin Park

• Dermatology Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Dermatology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.