NPIMap

Individual provider Active NPI

Kevin Ryan Parks, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Plainsboro, NJ
National Provider Identifier
1982090312
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
25MA10623700 Issued in NJ
Practice address
1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone
(609) 853-6049
Fax
(609) 853-7221
NPI assigned
Apr 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 25MA10623700 NJ Primary

Addresses

Primary practice location

1 Plainsboro Rd
Plainsboro, NJ 08536-1913

Mailing address

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 853-6049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190807002019 NJ Practitioner - HospitalistPractitioner - Internal Medicine 4981951696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone (609) 853-7272

1006 Mantua Pike
Woodbury, NJ 08097-1221

350 Forsgate Dr
Monroe, NJ 08831-5155

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jul 1, 2019 Accepting new patients
Clinical Health Care Associates of New Jersey, PC CurrentSince May 13, 2021 Accepting new patients
Princeton Healthcare Affiliated Physicians PC Geriatric Medicine Current Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince May 13, 2021 Accepting new patients
Princeton Healthcare Affiliated Physicians PC CurrentSince Jul 1, 2019 Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

401 Ridge Rd
Ste 6
Dayton, NJ 08810
Phone (732) 329-4800

350 Forsgate Dr
Ste 103
Monroe Twp, NJ 08831
Phone (609) 831-0779

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

5 Plainsboro Rd
Ste 300
Plainsboro, NJ 08536

1 Washington Blvd
Ste A
Trenton, NJ 08691
Phone (609) 448-4353

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1982090312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-6049",
            "fax_number": "609-853-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-6049",
            "fax_number": "609-853-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "KEVIN",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-13",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA10623700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainsboro, NJ

Sources for this page

Verify at the official NPI Registry.