Brenda Park, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OY012947 Issued in PA

Practice address

1550 N 115TH St
Seattle, WA 98133-8401

Phone

(206) 368-5762

Fax

(814) 537-5677

NPI assigned

Apr 23, 2009

Last updated

May 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Philadelphia College of Osteopathic Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpark4021658@ghc.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Ballard Emergency Physicians, P.S.

  • Emergency Medicine Physician
  • Seattle, WA
  • NPI 1619909256
  Medicare reassignment NPD
• Evergreen Emergency Services, PS

  • Emergency Medicine Physician
  • Kirkland, WA
  • NPI 1619912524
  Medicare reassignment
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Miners Hospital

  dba Miners Medical Center

  • Emergency Medicine Physician
  • Hastings, PA
  • NPI 1639135262
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1013151919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N 115TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338401",
            "telephone_number": "360-975-4784",
            "fax_number": "814-537-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N 115TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338401",
            "telephone_number": "206-368-5762",
            "fax_number": "814-537-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRENDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OY012947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1550 N 115th St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981338401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Park Place RHF Housing (Park Place Assisted Living)
• Olivia Park-Sargent, LMFT, PMH-C
• Alexander Jungho Park, MD
• Audrey Y Park, MD,PH.D
• Bohye Park
• Brian Park, MD
• Chankue Park, MD
• Christine Park, MD
• Christine Jungwon Park, D.D.S.
• Christopher Jin-Su Park, LMHC

• Emergency Medicine Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.