Individual provider Active NPI

Patricia Park

  • Endocrinology, Diabetes & Metabolism Physician
  • Murrieta, CA
National Provider Identifier
1700098282
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A83264 Issued in CA
Practice address
40663 Murrieta Hot Springs Rd
Murrieta, CA 92562-9022
Phone
(951) 200-6791
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 251075 NY
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A83264 CA Primary

Addresses

Primary practice location

40663 Murrieta Hot Springs Rd
Murrieta, CA 92562-9022

Mailing address

28078 Baxter Rd Ste 530
Murrieta, CA 92563-1405

Other practice location 1

984 50th St Fl 2
Brooklyn, NY 11219-3309
Phone (718) 283-5923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220714004144 CA Practitioner - Endocrinology 3971652272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
New York Medical College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical DoctorsGroup PAC ID 2961305651, 168 clinicians

Practice addresses (Care Compare)

40663 Murrieta Hot Springs Rd
Suite C1
Murrieta, CA 92562-9015
Phone (951) 200-6791

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A83264CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
United Medical Doctors CurrentSince Jul 15, 2022 Accepting new patients
United Medical Doctors CurrentSince Jul 15, 2022 Accepting new patients
Suny Health Science Center at Brooklyn Past Accepting new patients

Locations

2083 Compton Ave
Ste 104
Corona, CA 92881
Phone (951) 256-8191

521 E Elder St
Ste 104
Fallbrook, CA 92028
Phone (760) 728-9560

28078 Baxter Rd
Ste 530
Murrieta, CA 92563
Phone (951) 290-5472

40663 Murrieta Hot Springs Rd
Ste C1
Murrieta, CA 92562
Phone (951) 200-6791

40663 Murrieta Hot Springs Rd
Murrieta, CA 92562
Phone (951) 200-6791

400 Newport Center Dr
Ste 609
Newport Beach, CA 92660
Phone (949) 760-0398

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

Interoperability endpoints

  • Direct secure messaging: patricia.park.1@9170.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patriciapark@mai.allscriptsdirect.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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1700098282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28078 BAXTER RD STE 530",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40663 MURRIETA HOT SPRINGS RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629022",
            "telephone_number": "951-200-6791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "984 50th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112193309",
            "country_code": "US",
            "telephone_number": "718-283-5923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "251075",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A83264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.