Kristine Rachael Park, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT34525 Issued in CA

Practice address

10921 Wilshire Blvd Ste 900
Los Angeles, CA 90024-4003

Phone

(310) 208-3937

NPI assigned

Jul 5, 2019

Last updated

Nov 2, 2021By the provider in NPPES

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maloney-Shamie Vision InstituteGroup PAC ID 7012271992, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.54 of 100Reported as group

Quality

94.09

Improvement activities

40

Cost

59.67

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drpark@maloneyshamie.direct.eyemdemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maloney-Shamie Vision Institute

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1922501154
  Medicare reassignment Care Compare group NPD
• Gregg Feinerman MD Inc.

  dba Feinerman Vision Center

  • Specialist
  • Newport Beach, CA
  • NPI 1871665869
  Medicare reassignment NPD
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1821650383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SUPERIOR AVE STE 390",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926632793",
            "telephone_number": "949-631-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD STE 900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244003",
            "telephone_number": "310-208-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Superior Ave Ste 390",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "92663",
            "country_code": "US",
            "telephone_number": "949-631-4780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "KRISTINE",
        "middle_name": "RACHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-05",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT34525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Park, MD
• Kerry Park, M.D.
• Kevin Park, DDS
• Kihyun Park
• Kristian Park, PHARMD
• Kwang Soo Park, M.D.
• Kyu Park, MD
• Lisa Jieun Park
• Lisa S. Park, NP
• Louis Sang-Soo Park, M.D.

• Optometrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.