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

Dr. Peter Park, MD

Individual provider Surgery Physician · NPI 1164800850

Dr. Peter Park, MD is a General Surgery in Hackensack, New Jersey. Graduated from Jefferson Medical College of Thomas Jefferson University in 2015, 11 years ago. Practices with Hackensack Meridian Health Medical Group - Specialty Care PC, a 1,897-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Connecticut, New Jersey and Pennsylvania.

Years since qualifying
11
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
CT, NJ, PA
In the registry since
2015
Specialties on file
3
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

20 Prospect Ave Ste 901
Hackensack, NJ 07601-1974
Phone: (551) 996-4777
Fax: (551) 996-0800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 20 York St, New Haven, CT 06510-3220 — (203) 688-4242

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 25MA11518300 (NJ)
Surgery Physician Taxonomy 208600000X · Licence MT208732 (PA)
Surgery Physician Taxonomy 208600000X · Licence 68994 (CT)

Record details

NPI number1164800850
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 13, 2015
Last updated in NPPESNovember 23, 2022
Certification dateNovember 23, 2022
Mailing address3600 Route 66 Fl 3, Neptune, NJ 07753-2645

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 2015 (11 years in practice)
Group practice Hackensack Meridian Health Medical Group - Specialty Care Pc — 1897 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hackensack