Active NPI
Catherine Park, M.D.
- Pediatric Nephrology Physician
- Washington, DC
National Provider Identifier
1174968838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- MD048441
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2916 - Phone
- (202) 476-3409
- NPI assigned
- May 7, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nephrology Physician | 2080P0210X | MD048441 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
611 N Pegram St
Alexandria, VA 22304-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Medical College of Georgia School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Michigan Ave NW
Washington, DC 20010-2916
Phone (301) 572-3514
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78174 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Current | Accepting new patients | |
| Children'S Hospital | Pediatrics | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670
5285 Westview Dr
Ste 103
Frederick, MD 21703
Phone (301) 682-6661
Organizations & group practices 4
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.
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
-
- Pediatrics Physician
- Washington, DC
- NPI 1780800128
-
- Community/Retail Pharmacy
- Silver Spring, MD
- NPI 1326878349
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1174968838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N PEGRAM ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223042727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "202-476-3409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CATHERINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-07",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "DC",
"license": "MD048441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.