Justin Park, M.D.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

D0073546 Issued in MD

Practice address

1600 Crain Hwy S
Suite 401
Glen Burnie, MD 21061-5577

Phone

(410) 768-5050

Fax

(410) 768-7830

NPI assigned

Aug 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MD

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

Orthopedic Surgery

Education

Indiana University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians

Maryland Spine Center CharteredGroup PAC ID 0446142673, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Columbia, MD, CCN 217071
• Stella Maris, Inc. Home health agency, Timonium, MD, CCN 217072
• Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008

Merit-based Incentive Payment System (MIPS)

Final score

65.52 of 100Reported as individual

Quality

0

Promoting interoperability

100

Improvement activities

40

Cost

83.01

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpark34802@direct.mdmercy.com

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.

• Maryland Spine Center Chartered

  • Orthopaedic Surgery of the Spine Physician
  • Baltimore, MD
  • NPI 1952418535
  Medicare reassignment Care Compare group NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Olney, MD
  • NPI 1487093167

  Orthopaedic Surgery of the Spine

  Medicare reassignment NPD
• Agape Physical Therapy & Sports Rehabilitation LP

  • Physical Therapist
  • Forest Hill, MD
  • NPI 1578900668
  Care Compare group
• Amber Hill Physical Therapy, Inc.

  • Physical Therapist
  • Frederick, MD
  • NPI 1548290224
  Care Compare group
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Glen Burnie, MD
  • NPI 1508204389
  NPD
• Centers for Advanced Orthopaedics, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, VA
  • NPI 1063393833
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Columbia, MD
  • NPI 1922035880
  Care Compare affiliation
• Mercy Medical Center Inc

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1144282583
  Care Compare affiliation
• Stella Maris Inc.

  • Home Health Agency
  • Timonium, MD
  • NPI 1730295668
  Care Compare affiliation

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

{
    "created_epoch": "1188000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1265625941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CRAIN HWY S",
            "address_2": "SUITE 401",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615577",
            "telephone_number": "410-768-5050",
            "fax_number": "410-768-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CRAIN HWY S",
            "address_2": "SUITE 401",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615577",
            "telephone_number": "410-768-5050",
            "fax_number": "410-768-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-25",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "KY",
            "license": "43955",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MD",
            "license": "D0073546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC",
            "identifier": "253616",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "6831-0019",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN-- NORTON LEATHERMAN SPINE",
            "identifier": "K007170",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231508400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6029607",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "9804676",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "8543972",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parents' Place of Maryland, Inc.
• Park Dental
• Heejung Park, CPNP-PC
• Jaewoo Park, DDS
• Joseph Choi Park, M.D.
• Kee Jong Park, M.D.
• Matthew Park, M.D.
• Michele Parker-Evans, NCC
• Keturah Parker
• Parkway Medical Association LLC

• Orthopaedic Surgery of the Spine Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Orthopaedic Surgery of the Spine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.