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TAE JOON PARK DNP, PMHNP-BC
NPI 1134812761
Nurse Practitioner - Psychiatric/Mental Health in Baltimore, MD

Active since May 30, 2023PECOS Enrolled
921 E FORT AVE STE 100, BALTIMORE, MD 21230(667) 668-2566 Get Directions Write a Review

NPPES record last updated: July 14, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 14, 2023, May 30, 2023 (2 updates tracked since 2023).

About Tae Joon Park Dnp, Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAE JOON PARK DNP, PMHNP-BC (NPI 1134812761) is an individual psychiatric/mental health provider in Baltimore, Maryland, licensed in Maryland (R218239) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1134812761
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameTAE JOON PARKCredential: DNP, PMHNP-BC
Location Address921 E FORT AVE STE 100Baltimore, MD 21230-5135
Mailing Address603 S Rose StBaltimore, MD 21224-3759
Phone(667) 668-2566
Sole ProprietorYes
Enumeration DateMay 30, 2023
Last NPPES UpdateJuly 14, 20232 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1134812761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R218239
Also ListedRegistered NurseTaxonomy 163W00000X · License R218239 (MD)
921 E FORT AVE STE 100, Baltimore, MD 21230
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tae Joon Park Dnp, Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
137 services25 patients
Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
123 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21230 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE BAILEY
Physician Assistant
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 222-0284
PASSPORT HEALTH
Clinic/Center (Community Health)
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (410) 727-0556
RHIANON HOLCOMBE BRADY LCPC
Counselor
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 668-2566
CATHY YUJING WANG
Social Worker
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 222-0284
JANAYE MONICA
Social Worker (Clinical)
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 668-2566
ANDREW STEWART LGPC
Counselor (Mental Health)
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 668-2566
MADELINE KNIGHT
Counselor (Professional)
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 668-2566
MATTHEW REFFOLD
Social Worker
921 E FORT AVE STE 100
BALTIMORE, MD 21230
Baltimore City (667) 222-0284

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tae Joon Park's NPI number?

The NPI number for Tae Joon Park is 1134812761. It was assigned to this individual provider in the NPPES registry on May 30, 2023.

Where is Tae Joon Park located?

Tae Joon Park practices at 921 E Fort Ave Ste 100, Baltimore, MD 21230. The listed phone number is (667) 668-2566.

What is Tae Joon Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tae Joon Park enrolled in Medicare?

Yes. Tae Joon Park is registered in the Medicare PECOS enrollment system.

What insurance does Tae Joon Park accept?

Health plans from Providence Health Plan list Tae Joon Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tae Joon Park was last updated on July 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.