Frederick Kim Park, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

36793 Issued in NC

Practice address

4008 Capital Drive
Rocky Mount, NC 27804

Phone

(252) 937-5003

Fax

(252) 937-3020

NPI assigned

Aug 28, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

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 2

Specialty

Plastic and Reconstructive Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

James River Dermatology PLLCGroup PAC ID 1759430457, 9 clinicians

Park Plastic Surgery PAGroup PAC ID 3173599545, 2 clinicians

Wilmington Dermatology Center PLLCGroup PAC ID 0042385627, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

Merit-based Incentive Payment System (MIPS)

Final score

93.52 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

78.41

Merit-based Incentive Payment System (MIPS)

Final score

91.81 of 100Reported as group

Quality

94.68

Improvement activities

40

Cost

79.8

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EHDFAA
• Direct secure messaging: fpark114158@direct.unc.nchie.net
• FHIR API: https://fhir4.healow.com/fhir/r4/AGCHAA

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.

• Park Plastic Surgery, P.a.

  • Specialist
  • Rocky Mount, NC
  • NPI 1265533806
  Medicare reassignment Care Compare group NPD Authorized official
• Wilmington Dermatology Center, PLLC

  • Dermatology Physician
  • Wilmington, NC
  • NPI 1750537858
  Medicare reassignment Care Compare group NPD
• James River Dermatology PLLC

  • Dermatology Physician
  • Midlothian, VA
  • NPI 1508007840
  Medicare reassignment Care Compare group NPD
• James River Dermatology PLLC

  • Procedural Dermatology Physician
  • Mechanicsville, VA
  • NPI 1023550654
  NPD

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

• Nash Hospitals Inc

  • General Acute Care Hospital
  • Rocky Mount, NC
  • NPI 1619969219
  Care Compare affiliation

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1407964547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4008 CAPITAL DRIVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "27804",
            "telephone_number": "252-937-5003",
            "fax_number": "252-937-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 CAPITAL DRIVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "27804",
            "telephone_number": "252-937-5003",
            "fax_number": "252-937-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "FREDERICK",
        "middle_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "36793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407964547",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aurora K Pajeau, MD
• Carol Gibbons Paluch, CRNA
• Pam Specialty Hospital of Rocky Mount LLC
• Brett Paranzino
• Park Plastic Surgery, P.a.
• Irfan Umer Parkar, M.D.
• Destiny Parker-Nixon, DPT, PT
• Ashley Parker
• Dana Parker
• Kara Parker, DNP, FNP-BC

• Plastic Surgery Physician in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.