Individual provider Active NPI

Esther J Park, M.D.

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1417996414
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00045987 Issued in WA
Practice address
11511 NE 10TH St
Bellevue, WA 98004-8578
Phone
(425) 502-3000
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 217512 MA
Internal Medicine Physician 207R00000X MD00045987 WA Primary

Addresses

Primary practice location

11511 NE 10TH St
Bellevue, WA 98004-8578

Mailing address

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Other practice location 1

8301 161st Ave NE
Suite #308
Redmond, WA 98052-3858
Phone (425) 882-5020

Other identifiers 4

IdentifierTypeStateIssuer
5031PAOtherWABLUE SHIELD #
8467540MedicaidWA
P00348782OtherWARAILROAD MC #
US7557476OtherWAAETNA PCP PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20061006000106 WA Practitioner - Internal Medicine 2365494820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

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

State licenses

LicenseStateTypeSpecialty
217512MAMDInternal Medicine Physician
MD00045987WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince May 27, 2010 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince May 27, 2010 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: epark41442@ghc.direct-ci.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1417996414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8301 161st Ave NE",
            "address_2": "Suite #308",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523858",
            "country_code": "US",
            "telephone_number": "425-882-5020",
            "fax_number": "425-882-5021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ESTHER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "217512",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00045987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "5031PA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8467540",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC #",
            "identifier": "P00348782",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PCP PIN",
            "identifier": "US7557476",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.