Jakob Park, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD30217 Issued in ME

Practice address

96 Campus Dr
Scarborough, ME 04074-7163

Phone

(207) 885-9905

Fax

(207) 396-5600

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1841795416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747163",
            "telephone_number": "207-885-9905",
            "fax_number": "207-396-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 S San Vicente Blvd Ste A3100",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900483311",
            "country_code": "US",
            "telephone_number": "310-248-6719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAKOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": "MD30217",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A178342",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD30217",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A178342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Alyse Palminteri, OTD, OTR/L
• Sabrina H Palumbos, PHARM.D.
• Frank Paul Pantina Jr., PHARMD.
• Paradise Bay Care LL
• Gregory Thomas Paramantgis, PHARM D
• Samantha Louise Ciullo Parlin, LMSW-CC
• Henry Roy Partridge, MSW, PH.D.
• Pathways of Maine, Inc.
• Nicole Ann Patterson, FNP-BC
• Eric Payeur, PHARMD

• Cardiovascular Disease Physician in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Cardiovascular Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.