Individual provider Active NPI

Andrew Park, D.O., M.P.H.

  • Emergency Medicine Physician
  • Burlington, VT
National Provider Identifier
1841426319
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OP60948379 Issued in WA
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-0000
NPI assigned
Jun 10, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 032-0134126 VT
Emergency Medicine Physician 207P00000X OP60948379 WA Primary
Emergency Medicine Physician 207P00000X 00243361 NY
Emergency Medicine Physician 207P00000X 322420 NY

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

333 E 43Rd St Apt 220
New York, NY 10017-4814
Phone (646) 509-3362

Other practice location 1

75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 562-7408

Other practice location 2

183rd street and 3rd avenue
bronx, NY 10457
Phone (718) 960-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, WA, OK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090824000485 KS Practitioner - Emergency Medicine 5698829711 Reassigns benefits to 1 organization
I20241206001344 WA Practitioner - Emergency Medicine 5698829711 Reassigns benefits to 5 organizations
I20251229001801 OK Practitioner - Emergency Medicine 5698829711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians
Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians
Ballard Emergency Physicians PSGroup PAC ID 1052209368, 24 clinicians

Practice addresses (Care Compare)

1011 14TH Ave NW
Ardmore, OK 73401-1828
Phone (580) 220-6132

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1300

5300 Tallman Ave NW
Seattle, WA 98107-3932
Phone (206) 782-2700

5350 Tallman Ave NW
Seattle, WA 98107-5902
Phone (206) 782-2700

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 394-0610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9424OKMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
OP60948379WAMDEmergency Medicine Physician
00243361NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Jan 21, 2026 Accepting new patients
Ballard Emergency Physicians, P.S. Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Dec 1, 2025 Accepting new patients
Eastside Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Eastside Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Swedish Health Services CurrentSince Jan 1, 2025 Accepting new patients
Swedish Health Services CurrentSince Jan 1, 2025 Accepting new patients
Sound Physicians Emergency Medicine of Washington PLLC Emergency Medicine CurrentSince Dec 15, 2025 Accepting new patients
Sound Physicians Emergency Medicine of Kansas, LLC Emergency Medicine CurrentSince Nov 22, 2025 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Mar 1, 2026 Accepting new patients

Locations

1823 College Ave
Manhattan, KS 66502
Phone (785) 539-1704

1700 SW 7th St
Topeka, KS 66606
Phone (785) 295-5310

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Issaquah, WA 98029
Phone (425) 313-4000

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

18100 NE Union Hill Rd
Ste 200
Redmond, WA 98052
Phone (206) 320-5190

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

5300 Tallman Ave NW
Seattle, WA 98107
Phone (206) 781-6209

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: apark12675@direct.kuha.org

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1841426319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 43RD ST APT 220",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174814",
            "telephone_number": "646-509-3362",
            "fax_number": "484-303-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Beekman St",
            "address_purpose": "LOCATION",
            "city": "Plattsburgh",
            "state": "NY",
            "postal_code": "129011438",
            "country_code": "US",
            "telephone_number": "518-562-7408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "183rd street and 3rd avenue",
            "address_purpose": "LOCATION",
            "city": "bronx",
            "state": "NY",
            "postal_code": "10457",
            "country_code": "US",
            "telephone_number": "718-960-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "032-0134126",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP60948379",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "00243361",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "322420",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.