Carl H Park, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD420861 Issued in PA

Practice address

4060 Butler Pike
Suite 200
Plymouth Meeting, PA 19462-1560

Phone

(800) 331-6634

Fax

(267) 420-1360

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, NJ, DE3 enrollments

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 3

Specialty

Ophthalmology

Education

Mayo Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retinovitreous Associates LTDGroup PAC ID 2961485412, shared by 2 NPIs, 35 clinicians

Associated Retinal Surgeons, PAGroup PAC ID 9133170384, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wills Eye Hospital Hospital, Philadelphia, PA, CCN 390331

Merit-based Incentive Payment System (MIPS)

Final score

97.52 of 100Reported as group

Quality

96.59

Promoting interoperability

98

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.82 of 100Reported as group

Quality

97.86

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Associated Retinal Surgeons, PA

  • Ophthalmology Physician
  • Cherry Hill, NJ
  • NPI 1679625172
  Medicare reassignment Care Compare group
• Wills Eye Ophthalmology Clinic, Inc

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1184624009
  Medicare reassignment NPD
• Retinovitreous Associates LTD

  • Ophthalmology Physician
  • Plymouth Meeting, PA
  • NPI 1659326452
  Medicare reassignment
• Retinovitreous Associates LTD

  • Ophthalmology Physician
  • Wilmington, DE
  • NPI 1952552630
  Medicare reassignment
• Ocular Telehealth PC

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1548438518
  NPD (past)
• Ophthalmic Partners of Pennsylvania, PC

  • Ophthalmology Physician
  • Bala Cynwyd, PA
  • NPI 1912970666
  NPD (past)
• SCHC Pediatric Associates, LLC

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1255363578
  NPD (past)
• Ophthalmic Partners of Delaware, PA

  • Ophthalmology Physician
  • Wilmington, DE
  • NPI 1750355715
  NPD (past)
• Ophthalmic Partners of New Jersey, PC

  • Ophthalmology Physician
  • Marlton, NJ
  • NPI 1619940343
  NPD (past)
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD (past)

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

• City of Phila Trustee Acting by the BRD of Dir of City Trusts

  • Special Hospital
  • Philadelphia, PA
  • NPI 1881899284
  Care Compare affiliation

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1942274535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 BUTLER PIKE",
            "address_2": "SUITE 200",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621560",
            "telephone_number": "800-331-6634",
            "fax_number": "267-420-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 BUTLER PIKE",
            "address_2": "SUITE 200",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621560",
            "telephone_number": "800-331-6634",
            "fax_number": "267-420-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CARL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DE",
            "license": "C1-0006885",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07554800",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "DE",
            "license": "C1-0006885",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NJ",
            "license": "25MA07554800",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "PA",
            "license": "MD420861",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD420861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpark@midatlret.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4060 Butler Pike",
            "address_2": "Suite 200",
            "city": "Plymouth Meeting",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194621560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasline Panneerselvam
• Gerard Pantone, PTA
• Alesha Paradis
• Antonio Angelou Parham, R.N
• Dawn Paries
• Ho-Hyun Park, M.D.
• Sun Hee Park, CRNP
• Barbara Parker
• Diane Parker, LPN
• Elizabeth Parker, LPN

• Ophthalmology Physician in Plymouth Meeting, PA
• Providers in Plymouth Meeting, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.