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Dr. Jongbae Jay Park , KMD, PhD, LAC

Acupuncturist β€’ Durham, NC

Active NPI 1194987792 Individual Practitioner Male Practitioner
Practice location in NPPES

1910 Sedwick Rd Ste 400a
Durham, NC 277139428

Call 9198136636 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1910 Sedwick Rd Ste 400a

Durham, NC 277139428

Telephone 9198136636
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Raleigh, NC. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2008

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Durham and North Carolina

29 active clinicians are listed under Acupuncturist with a practice address in Durham, NC (479 in North Carolina).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Durham

0% of these 29 clinicians have the CMS telehealth indicator.

0% of these 29 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2020-10-09
Acupuncturist Primary Specialty

NUCC Taxonomy Code: 171100000X

License # reported to NPPES NC 490

An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: North Carolina Medical Board.
Look Up on State Board Site

Secondary Practice Locations

4822 Six Forks Rd, Suite 202

Raleigh, NC 276095269

Phone: 9197249985

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location October 09, 2020

Registered at 1910 SEDWICK RD STE 400A, DURHAM, NC 277139428 (Tel: 9198136636)

πŸ“
Updated Business Mailing Address October 09, 2020

Registered at 1910 SEDWICK RD STE 400A, DURHAM, NC 277139428 (Tel: 9198136636)

βœ…
NPI Profile Active May 17, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 17, 2012

Registered at 4822 SIX FORKS RD, SUITE 202, RALEIGH, NC 276095269 (Tel: 9197249985)

πŸ“
Business Mailing Address (Initial Record) May 17, 2012

Registered at 8408 INVERNESS WAY, CHAPEL HILL, NC 275167724 (Tel: 9199426969)

πŸ‘€
Provider Name / Credentials (Initial Record) May 17, 2012

Recorded as JONGBAE PARK, KMD, PHD, L.AC.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 17, 2012

Acupuncturist (license number reported to NPPES: NC 490)

🟒
Initial NPI Registration & Enumeration June 26, 2008

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1194987792
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 26, 2008
Last Update: October 09, 2020
Sole Proprietor: Yes

Mailing Address

1910 Sedwick Rd Ste 400a

Durham, NC 277139428

Phone: 9198136636

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.