Kenneth Park, M.D.

Primary specialty

Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X

License

A108380 Issued in CA

Practice address

5215 Torrance Blvd Ste 210
Torrance, CA 90503-4009

Phone

(310) 316-6190

Fax

(310) 540-7362

NPI assigned

May 31, 2007

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hollywood Home Health Services Home health agency, N Hollywood, CA, CCN 058310
• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kenneth.parkmd.p1@direct.bpasten.nextgenshare.com
• Direct secure messaging: kpark498345@direct.cshs.org

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.

• Cedars-Sinai Medical Care Foundation

  • Specialist
  • Los Angeles, CA
  • NPI 1316984388
  Medicare reassignment Care Compare group NPD
• Torrance Orthopaedic and Sports Medicine Group

  dba CoastalOrtho

  • Orthopaedic Surgery Physician
  • Torrance, CA
  • NPI 1104864131
  Medicare reassignment NPD
• Kenneth K. Park, M.D., Inc.

  • Non-Pharmacy Dispensing Site
  • Torrance, CA
  • NPI 1922418870
  Authorized official Same address or phone
• Torrance Orthopaedic and Sports Medicine Group

  dba CoastalOrtho

  • Orthopaedic Surgery Physician
  • Torrance, CA
  • NPI 1154834190
  NPD

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

• Hollywood Health System Inc

  dba Hollywood Home Health Services

  • Home Health Agency
  • North Hollywood, CA
  • NPI 1114996154
  Care Compare affiliation
• Providence Health System Southern California

  dba Providence Little Company of Mary Medical Center Torrance

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation
• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1881895316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 TORRANCE BLVD STE 210",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034009",
            "telephone_number": "310-316-6190",
            "fax_number": "310-540-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 TORRANCE BLVD STE 210",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034009",
            "telephone_number": "310-316-6190",
            "fax_number": "310-540-7362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 E Maple Ave",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902456507",
            "country_code": "US",
            "telephone_number": "310-316-6190",
            "fax_number": "310-540-0736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "TRN6888",
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "CA",
            "license": "A108380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiyoung Park, PHARMD
• Jonathan Keon Park
• Jong Hyuk Park
• Julie M Park, DDS
• Katie Mijin Park
• Michelle Park
• Michelle Park, M.D.
• Michelle Hansol Park, PHARM.D
• Royal Son Park, M.D.
• Sa Nan Park, MD, MPH

• Orthopaedic Foot and Ankle Surgery Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Orthopaedic Foot and Ankle Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.