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

Jaehan Park, MD

Individual provider Neurology Physician · NPI 1962995282

Jaehan Park, MD is a Neurology in Grand Rapids, Michigan. Qualified in 2009, 17 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
17
Licensed in
MI
In the registry since
2018
Specialties on file
2
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

100 Michigan St NE # MC019
Grand Rapids, MI 49503-2560
Phone: (616) 486-0310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurocritical Care Physician (primary) Taxonomy 2084A2900X · Licence 4301511476 (MI)
Neurology Physician Taxonomy 2084N0400X · Licence 4301511476 (MI)

Record details

NPI number1962995282
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 11, 2018
Last updated in NPPESAugust 6, 2024
Certification dateAugust 6, 2024

Medicare enrollment

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

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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