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JEONG SOO PARK MD
NPI 1356970701
Internal Medicine in Santa Clara, CA

Active since April 07, 2020PECOS EnrolledAccepts Medicare Assignment
710 LAWRENCE EXPY DEPT 384, SANTA CLARA, CA 95051(408) 851-3817 Get Directions Write a Review

NPPES record last updated: September 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 14, 2022, Apr 7, 2020 (2 updates tracked since 2020).

About Jeong Soo Park Md NPPES

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

JEONG SOO PARK MD (NPI 1356970701) is an individual internal medicine provider in Santa Clara, California, licensed in California (A183996) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (2020).

NPPES Registry Identity

NPI1356970701
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJEONG SOO PARKCredential: MD
Location Address710 LAWRENCE EXPY DEPT 384Santa Clara, CA 95051-5173
Mailing Address710 Lawrence Expy Dept 384Santa Clara, CA 95051-5173 · (408) 851-3817
Phone(408) 851-3817
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2020
Enumeration DateApril 7, 2020
Last NPPES UpdateSeptember 27, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 27, 2023
✔ NPI 1356970701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A183996
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
710 LAWRENCE EXPY DEPT 384, Santa Clara, CA 95051
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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

Jeong Soo Park Md 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 ID6507247426
PECOS Enrollment IDI20230411002256
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 Jeong Soo Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
0.1 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000

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 95051 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
$156.67 typical visit price
range $70.37 – $206.04
Typical copayment $39.16 (range $17.59 – $51.51)
Most-billed visit code 99204
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
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.

ANNA UNG
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3046
VINAYAKA MALAKKLA MD
Internal Medicine
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3830
DR. PETER K LEE D.O.
Internal Medicine
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-7215
JESSICA PUI WAH CHAU MD
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-1000
PHOEBE NGUYEN
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3817
NAVREEN PANDHER DO
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 709-6624
ALEX IM MD
General Practice
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3795
HANK CRAIG DAVIS MD
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY DEPT 384
SANTA CLARA, CA 95051
Santa Clara County (408) 851-3817

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 Jeong Soo Park's NPI number?

The NPI number for Jeong Soo Park is 1356970701. It was assigned to this individual provider in the NPPES registry on April 7, 2020.

Where is Jeong Soo Park located?

Jeong Soo Park practices at 710 Lawrence Expy Dept 384, Santa Clara, CA 95051. The listed phone number is (408) 851-3817.

What is Jeong Soo Park's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jeong Soo Park enrolled in Medicare?

Yes. Jeong Soo 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 Jeong Soo Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeong Soo Park reassigns Medicare benefits to Permanente Medical Group Inc (Santa Clara, 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 Jeong Soo 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 Jeong Soo Park was last updated on September 27, 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.