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JAY SUNGJAE PARK
NPI 1821797366
Oral & Maxillofacial Surgery in Seattle, WA

Active since February 23, 2023PECOS Enrolled
1959 NE PACIFIC ST, SEATTLE, WA 98195(415) 489-0499 Get Directions Write a Review

NPPES record last updated: July 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jay Sungjae Park NPPES

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

JAY SUNGJAE PARK (NPI 1821797366) is an individual oral & maxillofacial surgery provider in Seattle, Washington, licensed in Washington (DR61425062) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821797366
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameJAY SUNGJAE PARK
Location Address1959 NE PACIFIC STSeattle, WA 98195-0001
Mailing Address1959 Ne Pacific Street Box 357134Seattle, WA 98195-0001 · (415) 489-0499
Phone(415) 489-0499
Sole ProprietorNo
Enumeration DateFebruary 23, 2023
Last NPPES UpdateJuly 1, 2023
NPPES CertifiedJuly 1, 2023
✔ NPI 1821797366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in WA · DR61425062
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1959 NE PACIFIC ST, Seattle, WA 98195
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jay Sungjae Park 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.

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.

LEONIE A NEVILLE PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1959 NE PACIFIC ST
SEATTLE, WA 98195
King County (206) 598-4874
ALISA BETH KACHIKIS M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
1959 NE PACIFIC ST, 3RD FLOOR SW 350
SEATTLE, WA 98195
King County (206) 598-4070
MS. MARY PATRICIA DODGE MS, OTR/L
Occupational Therapist
1959 NE PACIFIC ST, MAILBOX 356490
SEATTLE, WA 98195
King County (206) 598-4830
RIKA SHIRAKAWA M.D.
Ophthalmology
1959 NE PACIFIC ST, BOX 365485
SEATTLE, WA 98195
King County (206) 558-9616
VEDA TSOI M.D.
Anesthesiology
1959 NE PACIFIC ST
SEATTLE, WA 98195
King County (801) 556-7628
KATHRYN TAMURA PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1959 NE PACIFIC ST, BOX 356015
SEATTLE, WA 98195
King County (206) 598-6060
DR. MARK ROBERT, MICHAEL KILGORE M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
1959 NE PACIFIC ST, BOX 356100
SEATTLE, WA 98195
King County (206) 598-1821
DR. SERKAN MEHMET SAHIN M.D.
Hospitalist
1959 NE PACIFIC ST
SEATTLE, WA 98195
King County (206) 543-6420

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 Jay Park's NPI number?

The NPI number for Jay Park is 1821797366. It was assigned to this individual provider in the NPPES registry on February 23, 2023.

Where is Jay Park located?

Jay Park practices at 1959 NE Pacific St, Seattle, WA 98195. The listed phone number is (415) 489-0499.

What is Jay Park's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Jay Park enrolled in Medicare?

Yes. Jay Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jay Park was last updated on July 1, 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.