Joseph Park, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E5726 Issued in CA

Practice address

309 E 2ND St
Pomona, CA 91766-1854

Phone

(909) 623-6116

NPI assigned

Apr 2, 2015

Last updated

Nov 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

De Anza Orthopedic Medical Group IncGroup PAC ID 9739481375, 18 clinicians

Western University of Health SciencesGroup PAC ID 0648208991, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

Merit-based Incentive Payment System (MIPS)

Final score

86.49 of 100Reported as group

Quality

68.78

Improvement activities

40

Cost

78.85

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jpark417961@direct.llu.edu

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.

• De Anza Orthopedic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Moreno Valley, CA
  • NPI 1255762340
  Medicare reassignment Care Compare group NPD
• Western University of Health Sciences

  dba WesternU Health

  • Family Medicine Physician
  • Pomona, CA
  • NPI 1679515217
  Medicare reassignment Care Compare group NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment NPD
• Western University of Health Sciences

  dba Western University Pharmacy

  • Pharmacy
  • Pomona, CA
  • NPI 1295051779
  NPD
• Western University of Health Sciences

  dba WesternU Health

  • Podiatrist
  • Pomona, CA
  • NPI 1689996100

  Foot & Ankle Surgery

  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD (past)
• Kaiser Foundation Health Plan of Georgia Inc.

  • Clinical Medical Laboratory
  • Tucker, GA
  • NPI 1932361789
  NPD (past)
• Mark Brian Friedman, DPM, PLLC

  dba Albany Podiatry

  • Podiatrist
  • Albany, NY
  • NPI 1225540248
  NPD (past)

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

• County of Riverside

  • General Acute Care Hospital
  • Moreno Valley, CA
  • NPI 1821159195
  Care Compare affiliation

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1306231600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 2ND ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661854",
            "telephone_number": "909-623-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Family Dentistry
• Park Avenue Optometry Inc
• James Park, LCSW
• Janice Hyan Park
• John Jongcheol Park, DDS
• Judith Y Park, PHARM.D.
• Michele Park, M.D.
• Domonique Olivia Parker
• Fahad Parker
• Isabelle Jennifer Parker

• Foot & Ankle Surgery Podiatrist in Pomona, CA
• Providers in Pomona, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.