Sara E.Q. Park, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

23844 Issued in AZ

Practice address

4000 N Central Ave
Comprehensive Medical & Dental, Azdcs, Sitecode C041-22
Phoenix, AZ 85012-1959

Phone

(602) 771-3638

Fax

(602) 351-8529

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Gastroenterology Physician
  • Phoenix, AZ
  • NPI 1356674469
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1790738698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29202",
            "address_2": "COMPREHENSIVE MEDICAL & DENTAL, AZDCS, SITECODE C041-22",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389202",
            "telephone_number": "602-771-3638",
            "fax_number": "602-351-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 N CENTRAL AVE",
            "address_2": "COMPREHENSIVE MEDICAL & DENTAL, AZDCS, SITECODE C041-22",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121959",
            "telephone_number": "602-771-3638",
            "fax_number": "602-351-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SARA",
        "middle_name": "E.Q.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "23844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339491",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kwiok Gloria Park
• Michelle Hae-Min Park, DO
• Michelle M Park, MD
• Naomi Park, MD
• Sabrina Park
• Sooyoung Park
• Stacy Park
• Susan S Park, P.N.P.
• Emily J Parke, D.O.
• Sara Parke, M.D.

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.