Individual provider Active NPI

Robert R Parks, M.D.

  • Otolaryngology Physician
  • Jefferson Valley, NY
National Provider Identifier
1801891916
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
187644 Issued in NY
Practice address
3680 Hill Blvd
Care Mount Medical, PC
Jefferson Valley, NY 10535-1500
Phone
(914) 245-7700
Fax
(914) 245-7836
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 187644 NY Primary

Addresses

Primary practice location

3680 Hill Blvd
Care Mount Medical, PC
Jefferson Valley, NY 10535-1500

Mailing address

110 S Bedford Rd
Care Mount Medical, PC
Mount Kisco, NY 10549-3446
Phone (914) 245-7700

Other identifiers 1

IdentifierTypeStateIssuer
01891001MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090409000286 NY Practitioner - Otolaryngology 2668545617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Columbia University College of Physicians and Surgeons, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187644NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince May 1, 2009 Accepting new patients
Optum Medical Care, P.C. CurrentSince May 1, 2009 Accepting new patients
Valley Ear, Nose and Throat Otolaryngology Past Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

60 Merritt Blvd
Fishkill, NY 12524
Phone (845) 440-1280

3680 Hill Blvd
Jefferson Valley, NY 10535
Phone (914) 245-7700

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: rparks218704@northwell.direct-ci.com
  • Direct secure messaging: rparks141884@direct.optum.com

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1801891916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S BEDFORD RD",
            "address_2": "CARE MOUNT MEDICAL, PC",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493446",
            "telephone_number": "914-245-7700",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 HILL BLVD",
            "address_2": "CARE MOUNT MEDICAL, PC",
            "city": "JEFFERSON VALLEY",
            "state": "NY",
            "postal_code": "105351500",
            "telephone_number": "914-245-7700",
            "fax_number": "914-245-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "187644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01891001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Valley, NY

Sources for this page

Verify at the official NPI Registry.