DR. JACQUELINE JEEYUNG PARK M.D.
NPI 1346415247
Internal Medicine - Gastroenterology in San Pablo, CA

Q: What is Jacqueline Park's NPI number?

The NPI number for Jacqueline Park is 1346415247. It was assigned to this individual provider in the NPPES registry on April 23, 2008.

Q: What is Jacqueline Park's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Park was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 23, 2008PECOS EnrolledAccepts Medicare Assignment

2089 VALE RD, SUITE 33, SAN PABLO, CA 94806(510) 234-5012(510) 234-4921 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Jacqueline Jeeyung Park M.d. NPPES

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

DR. JACQUELINE JEEYUNG PARK M.D. (NPI 1346415247) is an individual gastroenterology provider in San Pablo, California, licensed in California (A 109036) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and is a graduate of Yale University School Of Medicine (2002).

NPPES Registry Identity

NPI1346415247

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameDR. JACQUELINE JEEYUNG PARKCredential: M.D.

Location Address2089 VALE RD, SUITE 33San Pablo, CA 94806-3847

Mailing Address2089 Vale Rd, Suite 33San Pablo, CA 94806-3847 · (510) 234-5012 · Fax (510) 234-4921

Phone(510) 234-5012

Fax(510) 234-4921

Sole ProprietorNo

Medical School CMSYale University School Of MedicineGraduated 2002

Enumeration DateApril 23, 2008

Last NPPES UpdateDecember 15, 2021

✔ NPI 1346415247 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Licenses✔ Licensed in CA · A 109036✔ Licensed in NY · 234855-1

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

2089 VALE RD, San Pablo, CA 94806

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacqueline Jeeyung Park M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052460169

PECOS Enrollment IDI20090915000117

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.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

1.7 mi

Internal Medicine

901 NEVIN
Richmond, CA 94801

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1235226531 (510) 307-1555

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94806 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

$153.83 typical visit price

range $69.00 – $202.35

Typical copayment $38.45 (range $17.25 – $50.58)

Most-billed visit code 99204

Established Patient

$119.48 typical visit price

range $23.44 – $166.46

Typical copayment $29.87 (range $5.86 – $41.61)

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 19

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

DR. TERESA MARIE VAN WOY DPM

Podiatrist (Primary Podiatric Medicine)

2089 VALE RD, 12
SAN PABLO, CA 94806

Contra Costa County (510) 232-0892

DR. KHOSROW AFSARI FACP MD

Internal Medicine

2089 VALE RD, #21
SAN PABLO, CA 94806

Contra Costa County (510) 232-9065

WILLIAM ALBERT VAN DYK DDS

Dentist (General Practice)

2089 VALE RD, SUITE 30
SAN PABLO, CA 94806

Contra Costa County (510) 236-1662

ROBERT G. CLARK M.D.

Family Medicine

2089 VALE RD, SUITE 17
SAN PABLO, CA 94806

Contra Costa County (510) 237-2802

MARK SILVERT MD

Specialist

2089 VALE RD, SUITE 25
SAN PABLO, CA 94806

Contra Costa County (510) 235-1137

DR. MAHSA JABERIANSARI DDS

Dentist (General Practice)

2089 VALE RD, SUITE 15 AND 16
SAN PABLO, CA 94806

Contra Costa County (415) 746-9412

RAYNATO OCAMPO CASTRO JR. D.D.S.

Dentist (General Practice)

2089 VALE RD, STE 30
SAN PABLO, CA 94806

Contra Costa County (510) 236-1662

KIRAN FATIMA NARSINH M.D.

Internal Medicine (Gastroenterology)

2089 VALE RD, SUITE 33
SAN PABLO, CA 94806

Contra Costa County (510) 234-5012

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 Jacqueline Park's NPI number?

The NPI number for Jacqueline Park is 1346415247. It was assigned to this individual provider in the NPPES registry on April 23, 2008.

Where is Jacqueline Park located?

Jacqueline Park practices at 2089 Vale Rd Suite 33, San Pablo, CA 94806. The listed phone number is (510) 234-5012.

What is Jacqueline Park's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Jacqueline Park enrolled in Medicare?

Yes. Jacqueline Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jacqueline Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Park reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacqueline Park was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.