Richard Park, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A111560 Issued in CA

Practice address

10515 Balboa Blvd Ste 325
Granada Hills, CA 91344-6364

Phone

(186) 789-8758

Fax

(747) 200-2589

NPI assigned

Sep 12, 2007

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Affordable Urgent Care IncGroup PAC ID 0840617676, 4 clinicians

MVP Medical Group-a Professional Nursing CorporationGroup PAC ID 9436591492, 4 clinicians

Mobile Care Medical Group IncGroup PAC ID 7315330859, 4 clinicians

Espir Medical Group IncGroup PAC ID 7416328869, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Help Line Home Health Home health agency, Encino, CA, CCN 559733
• So Cal HHA Home health agency, N Hollywood, CA, CCN 053110
• Life of Hope Home Health Home health agency, Glendale, CA, CCN 757424
• G.S.a. Home Health Care, Inc Home health agency, Burbank, CA, CCN 559471
• La Pro Home Health Care, Inc Home health agency, Encino, CA, CCN 559597
• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: richard.park.1@27732.direct.athenahealth.com
• Direct secure messaging: richard.park@709457205592068.direct.elationemr.com

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.

• Affordable Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Canoga Park, CA
  • NPI 1992330690
  Medicare reassignment Care Compare group NPD
• Espir Medical Group Inc

  • Podiatrist
  • Van Nuys, CA
  • NPI 1831808062
  Medicare reassignment Care Compare group NPD
• Mobile Care Medical Group, Inc

  • Primary Care Nurse Practitioner
  • Union City, CA
  • NPI 1629642921
  Medicare reassignment Care Compare group NPD
• MVP Medical Group-a Professional Nursing Corporation

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1902651292
  Medicare reassignment Care Compare group NPD
• Palmdale Urgent Care Inc

  • Urgent Care Clinic/Center
  • Palmdale, CA
  • NPI 1699480038
  Medicare reassignment NPD Authorized official
• Richard Park M.D., a Professional Corporation

  • Multi-Specialty Clinic/Center
  • Granada Hills, CA
  • NPI 1982946323

  Internal Medicine

  Medicare reassignment NPD Authorized official
• Glenview MD Group Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Sun Valley, CA
  • NPI 1447104070
  Medicare reassignment NPD (past) Authorized official
• US Health Clinics

  • Urgent Care Clinic/Center
  • Sherman Oaks, CA
  • NPI 1598312001
  Medicare reassignment NPD
• Advantage Hospitalists Inc.

  • Internal Medicine Physician
  • Agoura Hills, CA
  • NPI 1801269881
  Medicare reassignment
• RPMD Medical, PC

  dba S&T Urgent Care of Simi Valley

  • Family Nurse Practitioner
  • Simi Valley, CA
  • NPI 1447123526
  NPD (past) Authorized official
• Santa Elena Medical Center, Inc.

  dba santa elena medical care

  • General Practice Physician
  • Pico Rivera, CA
  • NPI 1265617393
  NPD (past) Authorized official
• Carepath Medical Group Inc

  • Primary Care Nurse Practitioner
  • Glendale, CA
  • NPI 1851085948
  NPD

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

• G.S.a. Home Health Care, Inc.

  • Home Health Agency
  • Burbank, CA
  • NPI 1679042402
  Care Compare affiliation
• Help Line Home Health

  • Home Health Agency
  • Encino, CA
  • NPI 1679187223
  Care Compare affiliation
• La Pro Home Health Care, Inc.

  • Home Health Agency
  • Van Nuys, CA
  • NPI 1619471695
  Care Compare affiliation
• Life of Hope Home Health

  • Home Health Agency
  • Glendale, CA
  • NPI 1437826468
  Care Compare affiliation
• So Cal HHA

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1942608724
  Care Compare affiliation
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1174718134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 ROCKY POINT CT.",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91362",
            "telephone_number": "661-319-1908",
            "fax_number": "888-981-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 BALBOA BLVD STE 325",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913446364",
            "telephone_number": "186-789-8758",
            "fax_number": "747-200-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A111560",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A111560",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A111560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174718134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lusine Panikyan
• Mariam M Papazyan, PHARMD
• Violeta Papazyan, FNP
• Dong Keun Park, D.D.S
• Jin Park, DDS
• Farbod Parvinjah, D.M.D
• Neeraj M Patel, M.D.
• Path T0 Mindful Balanced Mental Wellness, Inc
• Path2 Recovery Center LLC
• Berdin Pattana

• Internal Medicine Physician in Granada Hills, CA
• Providers in Granada Hills, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.