Individual provider Active NPI

Brian Park

  • Physician Assistant
  • Germantown, MD
National Provider Identifier
1669929972
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C06204 Issued in MD
Practice address
20010 Century Blvd
Suite 200
Germantown, MD 20874-1115
Phone
(240) 686-2300
NPI assigned
Sep 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C06204 MD Primary

Addresses

Primary practice location

20010 Century Blvd
Suite 200
Germantown, MD 20874-1115

Mailing address

20010 Century Blvd
Suite 200
Germantown, MD 20874-1115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161213000209 DC Practitioner - Physician Assistant 0143500967 Reassigns benefits to 3 organizations
I20161213000742 MD Practitioner - Physician Assistant 0143500967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as group
Quality
80.29
Promoting interoperability
100
Improvement activities
40
Cost
75.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C06204MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Nov 1, 2016 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2022 Accepting new patients
WHC Emerg Phys CurrentSince Sep 1, 2020 Accepting new patients
Emergency Medicine Associates, PA CurrentSince Nov 1, 2016 Accepting new patients
WHC Physician Group LLC CurrentSince Sep 1, 2020 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Nov 1, 2016 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

20010 Century Blvd
Ste 200
Germantown, MD 20874

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Organizations & group practices 8

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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1669929972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20010 CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20010 CENTURY BLVD",
            "address_2": "SUITE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741115",
            "telephone_number": "240-686-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C06204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.