NPIMap

Individual provider Active NPI

Jane Park, M.D.

  • Colon & Rectal Surgery Physician
  • Brick, NJ
National Provider Identifier
1700939956
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
MD434270 Issued in PA
Practice address
478 Brick Blvd
Brick, NJ 08723-6077
Phone
(732) 701-4848
Fax
(732) 701-1244
NPI assigned
Jan 19, 2007
Last updated
Oct 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD434270 PA
Colon & Rectal Surgery Physician 208C00000X MD434270 PA Primary

Addresses

Primary practice location

478 Brick Blvd
Brick, NJ 08723-6077

Mailing address

478 Brick Blvd
Brick, NJ 08723-6077
Phone (732) 701-4848

Other identifiers 1

IdentifierTypeStateIssuer
02188022MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091120000072 NJ Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 8729127345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
State University of New York at Buffalo School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Shore Surgical Associates, PCGroup PAC ID 0446222533, 16 clinicians

Practice addresses (Care Compare)

208 Jack Martin Blvd
Suite C1
Brick, NJ 08724-7770
Phone (732) 701-4848

478 Brick Blvd
Brick, NJ 08723-6077
Phone (732) 701-4848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.54 of 100Reported as group
Quality
88.84
Improvement activities
40
Cost
70.01

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue23
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC CurrentSince Apr 1, 2018 Accepting new patients
Atlantic Shore Surgical Associates, PC Surgery CurrentSince Nov 1, 2013 Accepting new patients
Ocean Surgical & Oncology Associates, P.C PastSince Jul 1, 2010 Accepting new patients

Locations

478 Brick Blvd
Brick, NJ 08723
Phone (732) 701-4848

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

67 Route 37 W
Fl 3
Toms River, NJ 08755
Phone (732) 557-3541

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Organizations & group practices 3

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

Hospital & facility affiliations 8

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1700939956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 BRICK BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236077",
            "telephone_number": "732-701-4848",
            "fax_number": "732-701-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 BRICK BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236077",
            "telephone_number": "732-701-4848",
            "fax_number": "732-701-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD434270",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD434270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02188022",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.