Individual provider Active NPI

Jin Hong Park, MD

  • Gastroenterology Physician
  • Manassas, VA
National Provider Identifier
1225033038
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101234726 Issued in VA
Practice address
8640 Sudley Rd Ste 201
Manassas, VA 20110-4404
Phone
(703) 368-6819
Fax
(703) 330-2923
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101234726 VA Primary

Addresses

Primary practice location

8640 Sudley Rd Ste 201
Manassas, VA 20110-4404

Mailing address

PO Box 381468
Germantown, TN 38183-1468

Other practice location 1

7915 Lake Manassas Dr Ste 302
Gainesville, VA 20155-3260
Phone (571) 248-0653

Other practice location 2

170 W Shirley Ave Ste 205
Warrenton, VA 20186-3083
Phone (540) 347-2470

Other identifiers 2

IdentifierTypeStateIssuer
010000386MedicaidVA
1225033038MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110808000012 VA Practitioner - Gastroenterology 3274532221 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians
Gastroenterology Associates VA, LLCGroup PAC ID 2466449228, 51 clinicians

Practice addresses (Care Compare)

500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-8960

8640 Sudley Rd
Suite 201
Manassas, VA 20110-4404
Phone (703) 368-6819

8700 Sudley Rd
Manassas, VA 20110-4418
Phone (703) 396-5297

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy96
Upper gastrointestinal (GI) endoscopy for acid reflux128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince Aug 10, 2023 Accepting new patients
Uva Community Health Medical Group, LLC CurrentSince Aug 10, 2023 Accepting new patients
Martha Jefferson Medical Group LLC CurrentSince May 9, 2025 Accepting new patients
Martha Jefferson Hospital PastSince May 9, 2025 Accepting new patients

Locations

500 Martha Jefferson Dr
Ste 415C
Charlottesville, VA 22911
Phone (434) 654-8960

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1225033038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381468",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 SUDLEY RD STE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104404",
            "telephone_number": "703-368-6819",
            "fax_number": "703-330-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7915 Lake Manassas Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201553260",
            "country_code": "US",
            "telephone_number": "571-248-0653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 W Shirley Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "VA",
            "postal_code": "201863083",
            "country_code": "US",
            "telephone_number": "540-347-2470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JIN",
        "middle_name": "HONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101234726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010000386",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225033038",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.