NPIMap

Individual provider Active NPI

Robert Conrad Park, M.D.

  • Cardiovascular Disease Physician
  • Denton, TX
National Provider Identifier
1881695930
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
F4351 Issued in TX
Practice address
2725 Wind River LN
Denton, TX 76210-2999
Phone
(940) 390-2420
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X F4351 TX
Nuclear Cardiology Physician 207UN0901X F4351 TX
Cardiovascular Disease Physician 207RC0000X F4351 TX Primary

Addresses

Primary practice location

2725 Wind River LN
Denton, TX 76210-2999

Mailing address

PO Box 51587
Denton, TX 76206-1587
Phone (940) 390-2420

Other names 1

  • Dr. R. Conrad Park Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000342 TX Practitioner - Cardiovascular Disease (Cardiology) 3476503293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Texas Southwestern Medical School at Dallas, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3341 Unicorn Lake Blvd
Denton, TX 76210-0102
Phone (469) 814-4475

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F4351TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascularspecialty Associates of North Texas, PA Cardiovascular Disease Past Accepting new patients
Cardiovascular Specialty Associates of North Texas, P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cpark218592@direct.sw.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Aug 4, 2004
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Aug 4, 2004
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1881695930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51587",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762061587",
            "telephone_number": "940-390-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 WIND RIVER LN",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762102999",
            "telephone_number": "940-390-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ROBERT",
        "middle_name": "CONRAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "F4351",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "F4351",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "F4351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R. CONRAD",
            "last_name": "PARK",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.