Individual provider Active NPI

Andrea Park

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1396066205
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A148086 Issued in CA
Practice address
200 Medical Plaza
Ste 550
Los Angeles, CA 90024-0000
Phone
(310) 206-6688
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2010017830 MO
Otolaryngology Physician 207Y00000X A148086 CA Primary

Addresses

Primary practice location

200 Medical Plaza
Ste 550
Los Angeles, CA 90024-0000

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (314) 747-0553

Other practice location 1

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110-1003
Phone (314) 747-8130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170524000678 CA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 3577792712 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

400 Parnassus Ave
San Francisco, CA 94143-2202
Phone (415) 476-1000

400 Parnassus Ave
McB300
San Francisco, CA 94143-0810
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.01 of 100Reported as group
Quality
86.78
Improvement activities
40
Cost
70.46

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision45
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A148086CAMDOtolaryngology Physician
2010017830MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Jun 2, 2020 Accepting new patients
University of California San Francisco CurrentSince Aug 15, 2018 Accepting new patients
UCSF Medical Group Business Services Otolaryngology CurrentSince Aug 15, 2018 Accepting new patients
University of California SFGH Medical Group Otolaryngology Current Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Aug 15, 2018 Accepting new patients
University of California SFGH Medical Group CurrentSince Sep 1, 2018 Accepting new patients
University of California SFGH Medical Group CurrentSince Sep 1, 2018 Accepting new patients
University of California San Francisco CurrentSince Aug 15, 2018 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California San Francisco Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

1825 4th St
Fl 5
San Francisco, CA 94143
Phone (415) 353-2101

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

2320 Sutter St
Ste 102
San Francisco, CA 94115
Phone (415) 353-9500

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

1001 Potrero Ave
Rm 3A32
San Francisco, CA 94110
Phone (628) 206-8291

Interoperability endpoints

  • Direct secure messaging: apark100107@direct-ucsfmedicalcenter.org

Organizations & group practices 13

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 13

Hospital & facility affiliations 1

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396066205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "314-747-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "STE 550",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900240000",
            "telephone_number": "310-206-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "314-747-8130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2010017830",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A148086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.