Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jin S. Park, MD

Individual provider Nephrology Physician · NPI 1902842057

Dr. Jin S. Park, MD is a Nephrology in Brick, New Jersey. Qualified in 1968, 58 years ago. Practices with Northeast Kidney Care LLC, a 66-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
58
Licensed in
NJ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

210 Jack Martin Blvd Ste D-1
Brick, NJ 08724-7771
Phone: (732) 458-5067
Fax: (732) 458-4962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 34848 (NJ)

Record details

NPI number1902842057
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 20, 2006
Last updated in NPPESOctober 2, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 1968 (58 years in practice)
Group practice Northeast Kidney Care Llc — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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