1. Home
  2. Directory
  3. Virginia
  4. Roanoke
  5. Physician Assistant
  6. NPI Profile

JACLYN PARK
NPI 1851783708
Physician Assistant in Roanoke, VA

Active since March 02, 2015PECOS Enrolled
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014(540) 981-7000(540) 985-6920 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jaclyn Park NPPES

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

JACLYN PARK (NPI 1851783708) is an individual physician assistant in Roanoke, Virginia, licensed in Virginia (0110004841) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851783708
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJACLYN PARK
Location Address1906 BELLEVIEW AVE SERoanoke, VA 24014-1838
Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713
Phone(540) 981-7000
Fax(540) 985-6920
Sole ProprietorNo
Enumeration DateMarch 2, 2015
Last NPPES UpdateOctober 17, 2025
NPPES CertifiedOctober 17, 2025
✔ NPI 1851783708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in VA · 0110004841✔ Licensed in VA · 0110-004841
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1906 BELLEVIEW AVE SE, Roanoke, VA 24014
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24014 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
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.

JOHN K THOMPSON PA-C, ATC
Physician Assistant
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. JAMES LIGHT MD
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
SUJINA PRADHAN M.D.
Family Medicine
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
DR. SAMMY ZAKI ELSARRAG M.D.
Anesthesiology
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NIMA JAHROMI DO
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NICOLE SCHULTZ
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
TAYLOR ALEXIS KEYS
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000
NATHAN WILLIAM WAKEFIELD
Student in an Organized Health Care Education/Training Program
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014
Roanoke City (540) 981-7000

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 Jaclyn Park's NPI number?

The NPI number for Jaclyn Park is 1851783708. It was assigned to this individual provider in the NPPES registry on March 2, 2015.

Where is Jaclyn Park located?

Jaclyn Park practices at 1906 Belleview Ave SE, Roanoke, VA 24014. The listed phone number is (540) 981-7000.

What is Jaclyn Park's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jaclyn Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jaclyn Park was last updated on October 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.