JAEHAN PARK MD
NPI 1962995282
Psychiatry & Neurology - Neurocritical Care in Grand Rapids, MI

Q: What is Jaehan Park's NPI number?

The NPI number for Jaehan Park is 1962995282. It was assigned to this individual provider in the NPPES registry on June 11, 2018.

Q: What is Jaehan Park's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurocritical Care, with taxonomy code 2084A2900X.

Q: When was this NPI record last updated?

The NPPES record for Jaehan Park was last updated on August 6, 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 June 11, 2018PECOS EnrolledAccepts Medicare Assignment

100 MICHIGAN ST NE # MC019, GRAND RAPIDS, MI 49503(616) 486-0310 Get Directions Write a Review

NPPES record last updated: August 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2024, Jul 29, 2024, Apr 12, 2024 and 3 more (6 updates tracked since 2018).

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About Jaehan Park Md NPPES

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

JAEHAN PARK MD (NPI 1962995282) is an individual neurocritical care provider in Grand Rapids, Michigan, licensed in Michigan (4301511476) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1962995282

Entity TypeIndividualMale

Primary Taxonomy2084A2900X

Provider Legal NameJAEHAN PARKCredential: MD

Location Address100 MICHIGAN ST NE # MC019Grand Rapids, MI 49503-2560

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(616) 486-0310

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateJune 11, 2018

Last NPPES UpdateAugust 6, 20246 updates tracked since enumeration

NPPES CertifiedAugust 6, 2024

✔ NPI 1962995282 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Neurocritical CareAllopathic & Osteopathic Physicians

Taxonomy Code2084A2900X

License✔ Licensed in MI · 4301511476

Definition

The medical subspecialty of Neurocritical Care is devoted to the comprehensive, multisystem care of the critically-ill neurological patient. Like other intensivists, the neurointensivist generally assumes the primary role for coordinating the care of his or her patients in the ICU, both the neurological and medical management of the patient. They may also provide consultative services for these patients as requested within the health system.

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X · License 4301511476 (MI)

100 MICHIGAN ST NE # MC019, Grand Rapids, MI 49503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaehan 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 ID9537406616

PECOS Enrollment IDI20240606000833

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

32 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 10

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

HALEY LYNN STUTZKY NP

Nurse Practitioner (Gerontology)