Angela Park, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS21142 Issued in FL

Practice address

3302 Bonita Beach Rd Ste 170
Bonita Springs, FL 34134-4217

Phone

(239) 624-1050

Fax

(239) 624-1051

NPI assigned

Jun 20, 2019

Last updated

Aug 21, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Internal MedicineAlso: Hospitalist

Education

Arizona College of Osteopathic Medicine Mid Western University, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians

Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preferred Care Home Health Services Home health agency, Fort Myers, FL, CCN 109423
• Mederi Caretenders Home health agency, Fort Myers, FL, CCN 107406
• Patients First Home Care LLC Home health agency, Sarasota, FL, CCN 687176
• Trilogy Home Healthcare Home health agency, Estero, FL, CCN 108173
• Empath Home Health Home health agency, Fort Myers, FL, CCN 109786
• Naples Community Hospital Hospital, Naples, FL, CCN 100018
• Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195
  Medicare reassignment Care Compare group NPD
• Landmark Hospital of Southwest Florida, LLC

  • Long Term Care Hospital
  • Lehigh Acres, FL
  • NPI 1932595659
  NPD
• Nchmd, Inc

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1033904651
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bridges Home Health Inc.

  dba Trilogy Home Healthcare

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1376517862
  Care Compare affiliation
• KB Health Solutions, LLC

  dba Empath Home Health

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1659675106
  Care Compare affiliation
• Lee Health System Inc

  dba Lee Memorial Hospital

  • General Acute Care Hospital
  • Fort Myers, FL
  • NPI 1427806025
  Care Compare affiliation
• Mederi Caretenders VS of SW FL, LLC

  dba Mederi Caretenders

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1942481759
  Care Compare affiliation
• Naples Community Hospital Inc

  dba NCH Healthcare System Inc

  • General Acute Care Hospital
  • Naples, FL
  • NPI 1720085137
  Care Compare affiliation
• Patients First Home Care, LLC

  • Home Health Agency
  • Sarasota, FL
  • NPI 1245845312
  Care Compare affiliation
• Providia Home Care LLC.

  dba Preferred Care Home Health Services

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1245409010
  Care Compare affiliation

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1063073096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 BONITA BEACH RD STE 170",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344217",
            "telephone_number": "239-624-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 BONITA BEACH RD STE 170",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344217",
            "telephone_number": "239-624-1050",
            "fax_number": "239-624-1051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 N River St",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187642613",
            "country_code": "US",
            "telephone_number": "570-552-4450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142613",
            "country_code": "US",
            "telephone_number": "515-643-2261",
            "fax_number": "515-643-5802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANGELA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS023299",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R-11683",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS21142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary David Pajonk, R.N., L.M.T.
• Christopher Paladino, DPM
• Renee Palmer, LMHC
• Jyotin Pandit, MD
• John Michael Papandrea, ED.D.
• Stephen E Pascucci Jr., MD
• John Michael Pasicznyk, D.D.S
• Carly Pass, LCSW
• Saurabh N Patel, M.D.
• Pathfinder Performance & PT, LLC

• Internal Medicine Physician in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.