Individual provider Active NPI

James Y Park, DO

  • Emergency Medicine Physician
  • Urbana, IL
National Provider Identifier
1285830307
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036125968 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3311
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036125968 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

611 W. Park St.
Fapc
Urbana, IL 61803-6002

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20101117000283 IL Practitioner - Emergency Medicine 6305031212 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City University of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Emergency Medicine CurrentSince May 15, 2013 Accepting new patients
Crawford Hospital District Current Accepting new patients
Crawford Hospital District CurrentSince Aug 1, 2012 Accepting new patients
Crawford Hospital District CurrentSince Aug 1, 2012 Accepting new patients
Kirby Medical Center CurrentSince Jan 25, 2026 Accepting new patients

Locations

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jparkdo155248@carlehiedirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1285830307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JAMES",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036125968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.