NPIMap

Individual provider Active NPI

Caroline Park, MD PHD

  • Geriatric Medicine (Family Medicine) Physician
  • Los Angeles, CA
National Provider Identifier
1396270989
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A170021 Issued in CA
Practice address
1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312
Phone
(323) 442-5900
NPI assigned
Apr 21, 2017
Last updated
Sep 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X A170021 CA Primary

Addresses

Primary practice location

1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5900

Other identifiers 1

IdentifierTypeStateIssuer
390200000XOtherNYMOUNT SINAI BETH ISRAEL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001458 CA Practitioner - Geriatric MedicinePractitioner - Family PracticePractitioner - Internal Medicine 0840536157 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gap Post-Acute Care ServicesGroup PAC ID 9830619444, 14 clinicians
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

14857 Roscoe Blvd
Panorama City, CA 91402-4617
Phone (818) 667-6488

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

625 S Fair Oaks Ave
Pasadena, CA 91105-2684
Phone (626) 683-9000

625 S Fair Oaks Ave
Suite 250
Pasadena, CA 91105-2613
Phone (626) 795-5848

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
62.63 of 100Reported as apm
Quality
36.84
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A170021CAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jan 29, 2024 Accepting new patients
Gap Post-Acute Care Services CurrentSince Apr 1, 2025 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 16, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jan 29, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince Jan 29, 2024 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 16, 2024 Accepting new patients
County of Santa Clara CurrentSince Jan 29, 2024 Accepting new patients
County of Santa Clara Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Childrens Hospital of Los Angeles Past Accepting new patients
Usc Family Medicine Inc. PastSince Sep 23, 2024 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1520 San Pablo St
Ste 1300
Los Angeles, CA 90033
Phone (323) 442-5900

14857 Roscoe Blvd
Panorama City, CA 91402
Phone (818) 667-6488

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 10

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": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726358400000",
    "number": "1396270989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SAN PABLO ST STE 1300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335312",
            "telephone_number": "323-442-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A170021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNT SINAI BETH ISRAEL",
            "identifier": "390200000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.