Dr Jay Sung Park, DO - Medicare Radiology in Lakeland, FL

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Dr Jay Sung Park, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Lakeland, Florida. His current practice location is 1600 Lakeland Hills Blvd, Lakeland, Florida. You can reach out to his office (for appointments etc.) via phone at (863) 680-7000.

Dr Jay Sung Park is licensed to practice in Florida (license number OS11094) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1639167877.

Contact Information

Dr Jay Sung Park, DO
1600 Lakeland Hills Blvd,
Lakeland, FL 33805-3019
(863) 680-7000
(866) 264-8519

Map and Direction




Physician's Profile

Full NameDr Jay Sung Park
GenderMale
SpecialityRadiology - Diagnostic Radiology
Location1600 Lakeland Hills Blvd, Lakeland, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639167877
  • Provider Enumeration Date: 10/12/2005
  • Last Update Date: 04/10/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 1951552652
  • Enrollment ID: I20150810003000

Medical Identifiers

Medical identifiers for Dr Jay Sung Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639167877NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology OS11094 (Florida)Primary
2085R0202XRadiology - Diagnostic Radiology 24.000017 (Ohio)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jay Sung Park allows following entities to bill medicare on his behalf.
Entity NameMillennium Physician Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811122880
PECOS PAC ID: 9830244433
Enrollment ID: O20090903000338
Entity NameSmi Imaging Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972004489
PECOS PAC ID: 3476696220
Enrollment ID: O20181120002282
Entity NameRenaissance Radiology Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275181455
PECOS PAC ID: 0345571881
Enrollment ID: O20191111001664

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jay Sung Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jay Sung Park, DO
1600 Lakeland Hills Blvd,
Lakeland, FL 33805-3019

Ph: (863) 680-7000		Dr Jay Sung Park, DO
1600 Lakeland Hills Blvd,
Lakeland, FL 33805-3019

Ph: (863) 680-7000

Reviews and Comments


Radiology Doctors in Lakeland, FL

Dr. Kevin James Sawyer, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2125 Crystal Grove Dr, Lakeland, FL 33801
Phone: 863-688-2334    
Dr. Yelena Kozirovsky, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1420 Lakeland Hills Blvd, Lakeland, FL 33805
Phone: 863-680-7000    Fax: 866-264-8519
Dr. Michael Larone Campbell, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1305 Lakeland Hills Blvd, Lakeland, FL 33805
Phone: 863-688-2334    
Michael K Gordon, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2115 Crystal Grove Dr, Lakeland, FL 33801
Phone: 863-688-2334    Fax: 863-577-0303
Devashri Patel,
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1305 Lakeland Hills Blvd, Lakeland, FL 33805
Phone: 863-688-2334    
Alexander J Fernandez, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 2125 Crystal Grove Dr, Lakeland, FL 33801
Phone: 863-688-2334    
Jaehoon Bang, M.D.
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1600 Lakeland Hills Blvd, Lakeland, FL 33805
Phone: 863-680-7000    Fax: 866-264-8519

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.