Individual provider Active NPI

Edward Park, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bethesda, MD
National Provider Identifier
1245640374
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
0101258721 Issued in VA
Practice address
8901 Wisconsin Ave
Walter Reed National Military Medical Center
Bethesda, MD 20889-0004
Phone
(301) 295-4455
NPI assigned
Apr 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101258721 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101258721 VA Primary

Addresses

Primary practice location

8901 Wisconsin Ave
Walter Reed National Military Medical Center
Bethesda, MD 20889-0004

Mailing address

8901 Wisconsin Ave
Walter Reed National Military Medical Center
Bethesda, MD 20889-0004
Phone (301) 295-4455

Other practice location 1

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190819000007 DC Practitioner - Anesthesiology 6305170556 Reassigns benefits to 8 organizations
I20200326003284 VA Practitioner - Anesthesiology 6305170556 Reassigns benefits to 2 organizations
I20221006000900 MD Practitioner - Anesthesiology 6305170556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Northstar Anesthesia of Virginia, LLCGroup PAC ID 6608268826, 407 clinicians
Inova Cares - CommunityGroup PAC ID 9537526330, 187 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone (240) 434-4088

29955 Three Notch Rd
100 MMG at Charlotte Hall
Charlotte Hall, MD 20622-3159
Phone (301) 290-5300

3001 S Hanover St
Baltimore, MD 21225-1233

3600 Joseph Siewick Dr
Fairfax, VA 22033-1709
Phone (703) 391-3600

44045 Rivderside Pkwy
Leesburg, VA 20176-5101
Phone (703) 858-6000

7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 868-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
81.01
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101258721VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Oct 1, 2024 Accepting new patients
Inova Cares - Community Anesthesiology CurrentSince Jun 12, 2023 Accepting new patients
American Anesthesiology of Virginia, PC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients
Capitol Anesthesia Associates, LTD Anesthesiology CurrentSince May 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 1, 2024 Accepting new patients
Northstar Anesthesia of Maryland LLC Anesthesiology CurrentSince Apr 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Sep 1, 2022 Accepting new patients
Stonesprings Anesthesia Associates, LTD Anesthesiology CurrentSince Feb 1, 2020 Accepting new patients
Dominion Anesthesia, PLLC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Oct 1, 2024 Accepting new patients
Reston Anesthesia Associates, PC Anesthesiology CurrentSince Jul 27, 2019 Accepting new patients
American Anesthesiology of Virginia PC Anesthesiology CurrentSince Jun 1, 2021 Accepting new patients
Northstar Anesthesia of Virginia, LLC Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

6400 Goldsboro Rd
Ste 400
Bethesda, MD 20817
Phone (301) 263-0800

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

20680 Seneca Meadows Pkwy
Ste 200
Germantown, MD 20876
Phone (240) 608-6000

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

24570 Medical Dr
Sterling, VA 20166
Phone (571) 367-4400

24440 Stone Springs Blvd
Sterling, VA 20166
Phone (571) 206-8696

Interoperability endpoints

  • Direct secure messaging: epark164012@soc.inova.org
  • Direct secure messaging: edward.park.1@25225.direct.athenahealth.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1245640374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-295-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890004",
            "telephone_number": "301-295-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Joseph Siewick Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220331709",
            "country_code": "US",
            "telephone_number": "703-391-3129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101258721",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101258721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.