NPIMap

Individual provider Active NPI

Aaron Park

  • Internal Medicine Physician
  • Kentfield, CA
National Provider Identifier
1184120792
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A174413 Issued in CA
Practice address
1125 Sir Francis Drake Blvd
Kentfield, CA 94904-1418
Phone
(415) 456-9680
NPI assigned
Apr 3, 2018
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A174413 CA Primary

Addresses

Primary practice location

1125 Sir Francis Drake Blvd
Kentfield, CA 94904-1418

Mailing address

1123 191St St SW
Lynnwood, WA 98036-4961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210812000658 CA Practitioner - Internal Medicine 7416351432 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

173 E Webster St
Colusa, CA 95932-2949
Phone (209) 287-6308

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A174413CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Hospitalist Medical Group, Inc. Internal Medicine CurrentSince May 18, 2022 Accepting new patients
Pacific Inpatient Medical Group Internal Medicine CurrentSince Jul 24, 2023 Accepting new patients
Amplehealth Internal Medicine CurrentSince Aug 2, 2021 Accepting new patients
American Specialty Physicians Group Inc Internal Medicine CurrentSince Mar 27, 2024 Accepting new patients
Vibra Physicians LLC CurrentSince Aug 12, 2023 Accepting new patients
1125 Sir Francis Drake Boulevard Operating Company, LLC CurrentSince Aug 2, 2021 Accepting new patients

Locations

6620 Coyle Ave
Ste 202
Carmichael, CA 95608
Phone (916) 961-3434

6620 Coyle Ave
Ste 302
Carmichael, CA 95608
Phone (916) 966-8500

151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308

250 Bon Air Rd
Rm 3209
Greenbrae, CA 94904
Phone (415) 925-7545

336 Bon Air Ctr
Greenbrae, CA 94904
Phone (415) 461-1650

1125 Sir Francis Drk Blvd
Kentfield, CA 94904
Phone (415) 456-9680

700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851

3270 Arena Blvd
Ste 405
Sacramento, CA 95834
Phone (916) 418-4595

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

450 Stanyan St
Fl 6
San Francisco, CA 94117
Phone (415) 456-9680

Organizations & group practices 6

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1184120792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 191ST ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-456-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A174413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

Verify at the official NPI Registry.