Daniel Park, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

SL0537 Issued in NV

Practice address

4270 S Decatur Blvd Ste B6
Las Vegas, NV 89103-6802

Phone

(702) 485-2100

Fax

(702) 825-0091

NPI assigned

Dec 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, AZ2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medtrans Behavioral Nevada Casal PLLCGroup PAC ID 7810259165, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpark89149@direct.renown.org

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

• Medtrans Behavioral Nevada Casal, PLLC

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1245781160
  Medicare reassignment Care Compare group NPD
• Alliance Mental Health Specialists Suba Park Cheng PLLC

  • Psychiatry Physician
  • Las Vegas, NV
  • NPI 1275988107

  AZ

  Medicare reassignment NPD
• Medtrans Medical Nevada Casal PLLC

  • Community Health Clinic/Center
  • Las Vegas, NV
  • NPI 1750846549
  Medicare reassignment NPD
• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ely, NV
  • NPI 1760572010
  Medicare reassignment NPD
• Homebase Care Casal PLLC

  • Community/Behavioral Health Agency
  • Reno, NV
  • NPI 1942863253
  NPD
• Medtrans Reno Casal, PLLC

  • Family Medicine Physician
  • Reno, NV
  • NPI 1790236180
  NPD
• State of Nevada

  • Skilled Nursing Facility
  • Boulder City, NV
  • NPI 1083612741
  NPD
• State of Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elko, NV
  • NPI 1306936653
  NPD

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1124201801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 TRAILING PUTT WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891485003",
            "telephone_number": "951-809-5908",
            "fax_number": "702-947-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 S DECATUR BLVD STE B6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891036802",
            "telephone_number": "702-485-2100",
            "fax_number": "702-825-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1707 W Charleston Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022353",
            "country_code": "US",
            "telephone_number": "951-809-5908",
            "fax_number": "702-947-5352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "SL0537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Park, PA-C
• Anne Park, FNP
• Bo Park, OTD
• Bu Soon Park
• Chan Jerome Park, MD, PHD
• David Park
• Elana Imasa Park
• Elizabeth Yookyung Park, MD
• Eun-Mi Park, M.D.
• Hee Park

• Psychiatry Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.