Active NPI
Ki Eun Park, M.D.
- Interventional Cardiology Physician
- Dallas, TX
National Provider Identifier
1902994700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- V0095
- Practice address
- 5200 Harry Hines Blvd
Dallas, TX 75235-7709 - Phone
- (214) 590-8000
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | TRN10058 | FL | |
| Cardiovascular Disease Physician | 207RC0000X | ME104561 | FL | |
| Interventional Cardiology Physician | 207RI0011X | V0095 | TX | Primary |
Addresses
Primary practice location
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Mailing address
PO Box 845347
Dallas, TX 75284-7208
Phone (352) 262-9022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 012805200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8000
Hospital & facility affiliations
- Parkland Health & Hospital System
- Ut of Texas Southwestern University Hospital - William P. Clements Jr.
Merit-based Incentive Payment System (MIPS)
- Final score
- 47.54 of 100
- Quality
- 38.49
- Promoting interoperability
- 0
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.87 of 100
- Quality
- 70.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.75
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN10058 | FL | MD | Internal Medicine Physician |
| ME104561 | FL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Southwestern Medical Center at Dallas | Internal Medicine | Current | Accepting new patients |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients |
Locations
2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563
600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400
3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
2001 Inwood Rd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-8000
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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Pediatrics Physician
- Southlake, TX
- NPI 1275838732
Internal Medicine
Hospital & facility affiliations 46
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Family Planning Facility
- Dallas, TX
- NPI 1144397324
Hospital
-
- Sleep Disorder Diagnostic Clinic/Center
- Dallas, TX
- NPI 1164042784
Hospital
-
- Internal Medicine Physician
- Grand Prairie, TX
- NPI 1194090001
Hospital
-
- Ambulatory Family Planning Facility
- Dallas, TX
- NPI 1235206418
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1902994700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845347",
"city": "DALLAS",
"state": "TX",
"postal_code": "752847208",
"telephone_number": "352-262-9022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357709",
"telephone_number": "214-590-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "KI",
"middle_name": "EUN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "TRN10058",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "FL",
"license": "ME104561",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "TX",
"license": "V0095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "012805200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.