Tae Joon Park, DNP, PMHNP-BC in Baltimore, MD

Tae Joon Park, DNP, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Baltimore, Maryland. His current practice location is 921 E Fort Ave Ste 100, Baltimore, Maryland. You can reach out to his office (for appointments etc.) via phone at (667) 668-2566.

Tae Joon Park is licensed to practice in Maryland (license number R218239) 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 1134812761.

Contact Information

	Tae Joon Park, DNP, PMHNP-BC
	921 E Fort Ave Ste 100, Baltimore, MD 21230-5135
	(667) 668-2566
	Not Available

Map and Direction

Provider's Profile

Full Name	Tae Joon Park
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	921 E Fort Ave Ste 100, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134812761
Provider Enumeration Date: 05/30/2023
Last Update Date: 07/14/2023

Medicare PECOS Information:

PECOS PAC ID: 4082077409
Enrollment ID: I20230831002565

Medical Identifiers

Medical identifiers for Tae Joon Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134812761	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	R218239 (Maryland)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	R218239 (Maryland)	Primary

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. Tae Joon Park allows following entities to bill medicare on his behalf.

Entity Name	Psych Associates Of Maryland Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891721981 PECOS PAC ID: 3971550963 Enrollment ID: O20050401000288

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. Tae Joon 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 Address	Practice Location Address
Tae Joon Park, DNP, PMHNP-BC 603 S Rose St, Baltimore, MD 21224-3759 Ph: () -	Tae Joon Park, DNP, PMHNP-BC 921 E Fort Ave Ste 100, Baltimore, MD 21230-5135 Ph: (667) 668-2566

Reviews and Comments

Nurse Practitioner Nurses in Baltimore, MD

Ms. Lindsay Bream O'meara, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 22 S Greene St, Suite S4d07, Baltimore, MD 21201 Phone: 410-328-3365
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Kamishia Latasha Thomas, ANP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 601 N Caroline Street, Baltimore, MD 21264 Phone: 443-997-0270 Fax: 410-614-1168
Dana Aybout, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4940 Eastern Avenue, Baltimore, MD 21264 Phone: 410-550-5568 Fax: 410-550-0470
Andrew Brave, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2401 W Belvedere Ave, Baltimore, MD 21215 Phone: 410-601-9000

Tae Joon Park, DNP, PMHNP-BC - Medicare Nurse Practitioner in Baltimore, MD