Michael Kwansup Park, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

G75378 Issued in CA

Practice address

1940 Webster St
2ND Floor
Oakland, CA 94612-2920

Phone

(510) 463-4700

Fax

(510) 463-4722

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Physical Medicine and RehabilitationAlso: Neurosurgery

Education

University of Southern California Keck School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mpark420293@direct-ucsfmedicalcenter.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.

• Bay Area Comprehensive Spine and Sports Medical Group Inc

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Oakland, CA
  • NPI 1205928645
  Medicare reassignment NPD Authorized official
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment Care Compare group NPD
• UCSF Dept of Surgery

  • Surgery Physician
  • San Francisco, CA
  • NPI 1477627537
  Medicare reassignment NPD
• University of California San Francisco

  dba UCSF Pediatrics Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  dba UCSF Orthotic and Prosthetic Center - Gateway Medical Building

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  dba UCSF Outpatient Pharmacy at Parnassus

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD
• California Pacific Medical Group, Inc.

  dba Brown & Toland Medical Group

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1275002453
  NPD (past)
• University of California San Francisco Medical Center

  dba UCSF Medical Center

  • General Acute Care Hospital
  • San Francisco, CA
  • NPI 1144325440
  NPD (past)

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

• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Alta Bates Campus

  • General Acute Care Hospital
  • Berkeley, CA
  • NPI 1639523004
  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1932289030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 TELEGRAPH AVE",
            "address_2": "STE 100",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091710",
            "telephone_number": "510-463-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 WEBSTER ST",
            "address_2": "2ND FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122920",
            "telephone_number": "510-463-4700",
            "fax_number": "510-463-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MICHAEL",
        "middle_name": "KWANSUP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G75378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "E91026",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel C Park, M.D.
• Emily Hyo Jin Park, MD
• Janice Flora Park, PHARM.D.
• Jennifer Park
• Jun Hyeong Park, DDS
• Rosa Park
• Seojin Park
• Sori Park
• Sunghae Park
• Suzan Park, DDS

• Physical Medicine & Rehabilitation Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.