Tae J. Park, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

S1480 Issued in TX

Practice address

306 S Hampton Rd Ste 322
Dallas, TX 75208-5617

Phone

(469) 501-9205

Fax

(469) 629-1179

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Internal Medicine

Education

New York Medical College, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suvida Healthcare NphoGroup PAC ID 8325423650, 41 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: taepark@509680731226116.direct.elationemr.com

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.

• Suvida Healthcare Npho

  • Clinic/Center
  • Austin, TX
  • NPI 1033842414

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Carelon Medical Partners of Arizona, P.C.

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1730697483

  Single Specialty

  Medicare reassignment NPD
• Carelon Medical Partners of Arizona, P.C.

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1972879773

  Single Specialty

  NPD
• Caremore Medical Group

  • Physical Medicine & Rehabilitation Physician
  • Cerritos, CA
  • NPI 1770656829

  Single Specialty

  NPD (past)
• Caremore Medical Group Inc

  • Family Medicine Physician
  • Cerritos, CA
  • NPI 1760435705

  Single Specialty

  NPD (past)
• Rubin and McNamara MDS Inc

  • Hematology & Oncology Physician
  • La Mirada, CA
  • NPI 1659328219

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1346297660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 S HAMPTON RD STE 322",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085617",
            "telephone_number": "469-501-9205",
            "fax_number": "469-629-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 S HAMPTON RD STE 322",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752085617",
            "telephone_number": "469-501-9205",
            "fax_number": "469-629-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "TAE",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "S1480",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A90047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A900470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sangwook Park
• So Myung Park, DO
• Stephen Sangjin Park, M.D.
• Sungjin Park
• Susanna Park
• Yong Jong Park, DDS
• Parker University
• Allison Brooke Parker, CRNA
• April A Parker, LPC
• Carolyn K Parker, DDS

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.