Individual provider Active NPI

Jay H. Park, M.D.

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1366478372
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C171205 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
Fax
(888) 539-8781
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C171205 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other identifiers 2

IdentifierTypeStateIssuer
267471800MedicaidFL
79950OtherFLBLUE SHIELD OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120222000947 NY Practitioner - Emergency Medicine 7214977982 Reassigns benefits to 4 organizations
I20210816000932 CA Practitioner - Emergency Medicine 7214977982 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
George Washington University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C171205CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
New York University CurrentSince Aug 1, 2016 Accepting new patients
New York University Emergency Medicine CurrentSince Aug 1, 2016 Accepting new patients
Nes Medical Services of New York PC Emergency Medicine CurrentSince Feb 9, 2016 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
UC San Diego Health Community Group CurrentSince Jul 1, 2021 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2021 Accepting new patients
Nes Medical Services of New York PC Emergency Medicine Current Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Nes Medical Services of New York PC Emergency Medicine CurrentSince Feb 9, 2016 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Fpa Hospital Based CurrentSince Aug 1, 2014 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Jun 1, 2012 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Bimc Faculty Practice Emergency Medicine Past Accepting new patients
Gulfstream Emergency Physicians Emergency Medicine Past Accepting new patients
Inphynet South Broward LLC Emergency Medicine Past Accepting new patients
Regents of the University of California Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

8910 Villa La Jolla Dr
Ste 100
La Jolla, CA 92037

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

455 E Bay Dr
Long Beach, NY 11561
Phone (516) 432-8000

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 1

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1366478372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273",
            "fax_number": "888-539-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C171205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267471800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FL",
            "identifier": "79950",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.