Thomas Park, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301040933 Issued in MI

Practice address

23077 Greenfield #430
Southfield, MI 48075

Phone

(248) 552-0044

Fax

(248) 423-7777

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

PsychiatryAlso: Addiction Medicine, Neuropsychiatry, Pain Management

Education

Other, 1968

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Thomas Park M.D. PCGroup PAC ID 9032303813, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Thomas Park M.D. PC

  • Preferred Provider Organization
  • Southfield, MI
  • NPI 1881904605
  Medicare reassignment Care Compare group Authorized official
• A Better Tomorrow Counseling and Consultation Services, LLC

  • Mental Health Counselor
  • Redford, MI
  • NPI 1962763052
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1629169412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD #430",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-552-0044",
            "fax_number": "248-423-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD #430",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-552-0044",
            "fax_number": "248-423-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MI",
            "license": "040933",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301040933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "M13298001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jalpa Southeast Parekh
• Parent Pledge
• Heenal Parikh, PHARM.D
• Ahyoung Lyoo Park, PHARMD
• Bethany Lynn Park, PA-C
• Helen Parker-Smith, R.N
• Arnise Octavia Parker-Walker, MA, LPC
• Amy Parker, DDS
• Andrea E Parker, RN
• Bianca Parker, MD

• Psychiatry Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.