Kenneth H Park, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

25MB08263300 Issued in NJ

Practice address

680 Kinderkamack Rd
Suite 207
Oradell, NJ 07649-1600

Phone

(201) 487-7246

Fax

(201) 487-7246

NPI assigned

Jul 29, 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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Anesthesiology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physician Partners of Englewood PCGroup PAC ID 1153572482, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
• Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Merit-based Incentive Payment System (MIPS)

Final score

96.09 of 100Reported as apm

Quality

86.89

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpark241977@direct.englewoodhealth.org

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.

• Physician Partners of Englewood, PC

  • Internal Medicine Physician
  • Jersey City, NJ
  • NPI 1154671501
  Medicare reassignment Care Compare group NPD
• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment NPD
• Excelcare Medical Associates, PA

  • Internal Medicine Physician
  • Teaneck, NJ
  • NPI 1992736300
  NPD (past)
• Cap Anesthesia, PC

  • Anesthesiology Physician
  • Weston, MA
  • NPI 1497763213
  NPD (past)
• Capa Anesthesia LLC

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1629723002
  NPD (past)
• Caritas Medical Group, Inc.

  • Specialist
  • Brighton, MA
  • NPI 1174513204
  NPD (past)

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

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation
• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation
• Kessler Institute for Rehabilitation Inc

  • Rehabilitation Hospital
  • West Orange, NJ
  • NPI 1013919620

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1609881978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 207",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-487-7246",
            "fax_number": "201-225-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 KINDERKAMACK RD",
            "address_2": "SUITE 207",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491600",
            "telephone_number": "201-487-7246",
            "fax_number": "201-487-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KENNETH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MB08263300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oradell Medical Imaging Center, LLC
• Young Hyun Pak, D.D.S.
• Palisades Surgical Associates, P.C.
• Lillian Paredes, MD
• Chun Y Park, DMD
• Pathways to Healing & Social Justice
• Peak Home Based Rehabilitation LLC
• Personal Solutions, LLC
• Donna Philibosian
• Jucelia S Pitt, LCSW

• Pain Medicine (Anesthesiology) Physician in Oradell, NJ
• Providers in Oradell, NJ by specialty
• Pain Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.