Individual provider Active NPI

Stephen Andre Parks, M.D.

  • Anesthesiology Physician
  • Los Angeles, CA
National Provider Identifier
1881607604
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G65543 Issued in CA
Practice address
1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone
(134) 133-0002
Fax
(323) 666-2939
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G65543 CA Primary

Addresses

Primary practice location

1300 N Vermont Ave
Los Angeles, CA 90027-6098

Mailing address

PO Box 25033
Santa Ana, CA 92799-5033
Phone (714) 347-1000

Other identifiers 2

IdentifierTypeStateIssuer
00G655430MedicaidCA
00G655430OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050813000265 CA Practitioner - Anesthesiology 0941230536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Ohio, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HP Anesthesia IncGroup PAC ID 6608009766, 34 clinicians

Practice addresses (Care Compare)

1300 N Vermont Ave
Los Angeles, CA 90027-6005

1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (213) 413-3000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Axiom Anesthesia Group Inc Anesthesiology CurrentSince Jul 1, 2018 Accepting new patients
HP Anesthesia Inc Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients

Locations

2131 W 3rd St
#1182
Los Angeles, CA 90057
Phone (213) 484-7111

2131 W 3rd St
Los Angeles, CA 90057
Phone (213) 484-5525

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

514 N Prospect Ave
Ste 100
Redondo Beach, CA 90277
Phone (310) 376-2007

Organizations & group practices 2

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 1

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1881607604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25033",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927995033",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276098",
            "telephone_number": "134-133-0002",
            "fax_number": "323-666-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "STEPHEN",
        "middle_name": "ANDRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G65543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G655430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G655430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.