Albert Park, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036.152196 Issued in IL

Practice address

2570 24TH St Ste 124
Rock Island, IL 61201-5394

Phone

(309) 779-3670

NPI assigned

Apr 5, 2016

Last updated

Aug 29, 2020By 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 IA, IL2 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

Physical Medicine and Rehabilitation

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Genesis Medical Center-Davenport Hospital, Davenport, IA, CCN 160033
• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apark117259@direct.metrohealth.org
• Direct secure messaging: apark761265@direct.unitypoint.org

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.

• Iowa Physicians Clinic Medical Foundation

  dba UnityPoint Clinic

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274

  IL, Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD

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

• Trinity Medical Center

  dba Trinity Rock Island

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation
• Genesis Health System

  dba Genesis Medical Center Davenport

  • General Acute Care Hospital
  • Davenport, IA
  • NPI 1972542264
  Care Compare affiliation

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1538523626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 24TH ST STE 124",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015394",
            "telephone_number": "309-779-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 24TH ST STE 124",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015394",
            "telephone_number": "309-779-3670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-4486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "MA",
            "postal_code": "02129",
            "country_code": "US",
            "telephone_number": "617-952-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4480 Utica Ridge Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527221637",
            "country_code": "US",
            "telephone_number": "563-742-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036.152196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Outreach Medical, Inc.
• Gloria Pagan, MS CCC-SLP
• Sanjay Suryakant Pancholi, D.O.
• Caleb Paniamogan, DO
• Kerry P Panozzo, MD
• Stephane Gail Parker, LCPC
• La'Cretsia S Parrow
• Jordan Parsons
• Aamir Pasha, M.D.
• Axi R Patel, MD, MPH

• Physical Medicine & Rehabilitation Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.