Individual provider Active NPI

Richard Y Pak, MD

  • Family Medicine Physician
  • Hermitage, TN
National Provider Identifier
1710968037
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 40197 Issued in TN
Practice address
3939 Central Pike
Hermitage, TN 37076
Phone
(615) 883-2331
Fax
(615) 391-1785
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD 40197 TN Primary

Addresses

Primary practice location

3939 Central Pike
Hermitage, TN 37076

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

Other identifiers 1

IdentifierTypeStateIssuer
3334384MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20051013001032 TN Practitioner - Family Practice 8224053665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 40197TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC CurrentSince Oct 1, 2019 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Oct 1, 2019 Accepting new patients

Locations

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

3939 Central Pike
Ste 100
Hermitage, TN 37076
Phone (615) 883-2331

3939 Central Pike
Hermitage, TN 37076
Phone (615) 391-1515

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

Interoperability endpoints

  • Direct secure messaging: richard.pak@ahp.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1710968037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 CENTRAL PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "37076",
            "telephone_number": "615-883-2331",
            "fax_number": "615-391-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "RICHARD",
        "middle_name": "Y",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD 40197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3334384",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

Verify at the official NPI Registry.