Peter K Park, D.O.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

OP61483972 Issued in WA

Practice address

3909 9TH Ave SW
Olympia, WA 98502-5134

Phone

(360) 570-3460

NPI assigned

Mar 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physical Medicine and Rehabilitation

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Olympia Orthopaedic Associates PLLCGroup PAC ID 2365337508, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031
• Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

Merit-based Incentive Payment System (MIPS)

Final score

88.86 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

87.45

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.park.1@5512.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

• Olympia Orthopaedic Associates PLLC

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1083785398
  Medicare reassignment Care Compare group NPD
• Olympia Orthopaedic Associates, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Centralia, WA
  • NPI 1134089576
  NPD

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

• Grays Harbor Community Hospital

  • General Acute Care Hospital
  • Aberdeen, WA
  • NPI 1154378859
  Care Compare affiliation
• Public Hospital District No 1 of Mason County

  • Clinic/Center
  • Shelton, WA
  • NPI 1700111986

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County

  • Critical Access Hospital
  • Shelton, WA
  • NPI 1760568752
  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  • Foot & Ankle Surgery Podiatrist
  • Shelton, WA
  • NPI 1437486248

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  • Surgery Physician
  • Shelton, WA
  • NPI 1639339666

  Hospital

  Care Compare affiliation
• Public Hospital District No 1 of Mason County Washington

  • Ophthalmologic Surgery Clinic/Center
  • Shelton, WA
  • NPI 1922196609

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1831650043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 9TH AVE SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025134",
            "telephone_number": "314-362-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 9TH AVE SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025134",
            "telephone_number": "360-570-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "PETER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2023000432",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2020011741",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "OP61483972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Park, D.O.
• Eunseo Park, RPH
• Jessica Park
• Jiyoung Park, PHARMD
• Lauren C Park, PT, DPT
• Rachel Park, OT
• Sea Mi Park, M.D. ,PH.D.
• Amanda Louise Parker, AACR
• Ana R Parker, MD
• Gevin Parker, PA-C

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.