Boram Kim Park, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

Q6083 Issued in TX

Practice address

3607 Oak Lawn Ave Ste 270
Dallas, TX 75219-4743

Phone

(214) 375-6262

Fax

(214) 375-6266

NPI assigned

Apr 4, 2011

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Boram Rachel Kim Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Internal Medicine

Education

Northwestern University Feinberg Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21213/brand/1/csg/1/fhir/r4
• Direct secure messaging: rachel.park.1@21213.direct.athenahealth.com

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.

• Boram Park, M.D., PLLC

  dba Highland Park Concierge Medicine

  • Clinic/Center
  • Dallas, TX
  • NPI 1821616566
  Medicare reassignment NPD Authorized official
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936

  Internal Medicine

  Medicare reassignment NPD
• Medhealth

  dba Methodist Medical Group

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200

  Internal Medicine

  Medicare reassignment NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Flower Mound, TX
  • NPI 1427054402
  NPD
• Healthtexas Provider Network--Dallas Diagnostic Association

  • Dermatology Physician
  • Garland, TX
  • NPI 1255337275

  Internal Medicine

  NPD
• Healthtexas-Dallas Diagnostic Association

  dba Dallas Diagnostic Association

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1245235886
  NPD
• Medhealth

  dba Methodist Medical Group

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1881983468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 OAK LAWN AVE STE 270",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194743",
            "telephone_number": "214-375-6262",
            "fax_number": "214-375-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 OAK LAWN AVE STE 270",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194743",
            "telephone_number": "214-375-6262",
            "fax_number": "214-375-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BORAM",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q6083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BORAM",
            "last_name": "KIM",
            "middle_name": "RACHEL",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Park Lane Allergy and Asthma Center, PA
• Park Lane Medical Group P.a.
• Park Lane Surgery Center
• Auh Whan Park, M.D.
• Betty J Park, M.D.
• Byung Joo Park
• Byung Ryang Park, MD
• Caroline Park, M.D.
• Charisse Park
• Dale Park, CERTPS

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.