Individual provider Active NPI

Jun Hyoung Park, PA-C

  • Physician Assistant
  • Bear, DE
National Provider Identifier
1770460925
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
121 Becks Woods Dr Ste 100
Bear, DE 19701-3853
Phone
(302) 261-5600
Fax
(302) 836-4302
NPI assigned
Aug 19, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

121 Becks Woods Dr Ste 100
Bear, DE 19701-3853

Mailing address

121 Becks Woods Dr Ste 100
Bear, DE 19701-3853
Phone (302) 261-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015002571 DE Practitioner - Physician Assistant 9830686658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4932 Hogan Dr
Wilmington, DE 19808-1755

800 Delaware Ave
FL 5
Wilmington, DE 19801-1324

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glasgow Family Practice PA Current Accepting new patients
United Medical Clinic, LLC CurrentSince Sep 29, 2025 Accepting new patients

Locations

121 Becks Woods Dr
Ste 100
Bear, DE 19701
Phone (302) 836-8200

Organizations & group practices 2

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 2

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": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1770460925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BECKS WOODS DR STE 100",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013853",
            "telephone_number": "302-261-5600",
            "fax_number": "302-836-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BECKS WOODS DR STE 100",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013853",
            "telephone_number": "302-261-5600",
            "fax_number": "302-836-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUN",
        "middle_name": "HYOUNG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bear, DE

Sources for this page

Verify at the official NPI Registry.