Jung Ki Park, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA09881800 Issued in NJ

Practice address

185 S Orange Ave
MSB E-532
Newark, NJ 07103-2757

Phone

(973) 972-5482

Fax

(973) 972-4574

NPI assigned

Apr 19, 2011

Last updated

Jan 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: jupark@montefioredirect.com

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.

• University Physician Associates of New Jersey Inc

  dba University of OBGYN Associates

  • Obstetrics & Gynecology Physician
  • Newark, NJ
  • NPI 1922018514
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment
• University Physician Associates of New Jersey Inc

  dba University Medical Associates

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1760492367
  NPD
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323
  NPD (past)
• Montefiore Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1952476988
  NPD (past)

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1922399351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "MSB E-532",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-5482",
            "fax_number": "973-972-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "MSB E-532",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-5482",
            "fax_number": "973-972-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG KI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "183815-1",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA09881800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpark66309@direct-uhnj.org",
            "affiliation": "Y",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Park Place Oral Surgery LLC
• Benjamin Park
• Chan Woo Park, M.D.
• Claire S Park, MD
• Jonghanne Park, MD
• Krystle Haver Park, APRN
• Min Jung Park, DO
• Shane Park
• Parker-All-Inclusive-Care LLC
• Lynn Renay Parker, NP

• Obstetrics & Gynecology Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.