Steven J Park, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

1983 Issued in WA

Practice address

395 Cascade Mall Dr
Burlington, WA 98233-3255

Phone

(360) 757-7750

Fax

(360) 757-7756

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Muckleshoot Indian TribeGroup PAC ID 5092724286, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Muckleshoot Indian Tribe

  • Clinic/Center
  • Auburn, WA
  • NPI 1558448175

  TX

  Medicare reassignment Care Compare group NPD
• Paris Miki Inc.

  • Optician
  • Bellevue, WA
  • NPI 1720131881
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1730306374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 CASCADE MALL DR",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333255",
            "telephone_number": "360-757-7750",
            "fax_number": "360-757-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 CASCADE MALL DR",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333255",
            "telephone_number": "360-757-7750",
            "fax_number": "360-757-7756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17500 SE 392nd St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980929705",
            "country_code": "US",
            "telephone_number": "253-939-6648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "1983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017720",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019743",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBS",
            "identifier": "8772PA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxanne Ocampo, M.A.
• Ojh Clinic No 5 Inc.-Burlington Family Dentistry
• Deanne Orlando
• Richard V Orskog
• Donald Owens
• Erin Parker, LMP
• Michelle R Parkinson, R.PH.
• Seth Orin Peebles
• Pembhi, LLC
• Juleen Perusek

• Corneal and Contact Management Optometrist in Burlington, WA
• Providers in Burlington, WA by specialty
• Corneal and Contact Management Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.