JAEHO PARK MD
NPI 1477384287
Internal Medicine - Gastroenterology in Little Rock, AR

Q: What is Jaeho Park's NPI number?

The NPI number for Jaeho Park is 1477384287. It was assigned to this individual provider in the NPPES registry on August 13, 2024.

Q: What is Jaeho 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 Jaeho Park was last updated on September 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 August 13, 2024PECOS EnrolledAccepts Medicare Assignment

4301 W MARKHAM ST # 520, LITTLE ROCK, AR 72205(501) 686-8000(501) 526-5148 Get Directions Write a Review

NPPES record last updated: September 13, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 13, 2024, Aug 13, 2024 (2 updates tracked since 2024).

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About Jaeho Park Md NPPES

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

JAEHO PARK MD (NPI 1477384287) is an individual gastroenterology provider in Little Rock, Arkansas, licensed in Arkansas (E-18398) and active in the NPI registry since August 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1477384287

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameJAEHO PARKCredential: MD

Location Address4301 W MARKHAM ST # 520Little Rock, AR 72205-7101

Mailing Address4301 W Markham St # 783Little Rock, AR 72205-7101 · (501) 686-8000 · Fax (501) 526-5128

Phone(501) 686-8000

Fax(501) 526-5148

Sole ProprietorNo

Medical School CMSOtherGraduated 2002

Enumeration DateAugust 13, 2024

Last NPPES UpdateSeptember 13, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 13, 2024

✔ NPI 1477384287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in AR · E-18398

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.

Also ListedInternal MedicineTaxonomy 207R00000X · License E-18398 (AR)

4301 W MARKHAM ST # 520, Little Rock, AR 72205

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

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

Jaeho 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 ID6507306727

PECOS Enrollment IDI20241011004080

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 Reassignments

Medicare enrollment records show Jaeho Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Arkansas For Medical Sciences

Same address

Advanced Practice Midwife

4301 W MARKHAM ST # 783
Little Rock, AR 72205

Reassigned Medicare billing, Arkansas enrollment
2,038 clinicians in this Medicare group

NPI 1043372220 (501) 686-8000

University Of Florida Jacksonville Physicians Inc

691 mi

Nephrology

655 W 8TH ST, UFJP NEPHROLOGY
Jacksonville, FL 32209

Reassigned Medicare billing, Florida enrollment
1,456 clinicians in this Medicare group

NPI 1295995561 (904) 244-3660

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 72205 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

$119.36 typical visit price

range $51.36 – $157.74

Typical copayment $29.84 (range $12.84 – $39.43)

Most-billed visit code 99204

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

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 20

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

SANDRA MINERVA GARCIA OSOGOBIO MD

Colon & Rectal Surgery