Individual provider Active NPI

Joseph Park, DPM

  • Foot & Ankle Surgery Podiatrist
  • Burbank, CA
National Provider Identifier
1982886412
Registry record updated Feb 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4797 Issued in CA
Practice address
191 S Buena Vista St Ste 315
Burbank, CA 91505-4556
Phone
(818) 848-5586
NPI assigned
Nov 27, 2007
Last updated
Feb 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4797 CA Primary

Addresses

Primary practice location

191 S Buena Vista St Ste 315
Burbank, CA 91505-4556

Mailing address

191 S Buena Vista St Ste 315
Burbank, CA 91505-4556
Phone (818) 848-5586

Other identifiers 1

IdentifierTypeStateIssuer
1982886412OtherCAPODIATRY

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090728000352 CA Practitioner - Podiatry 1355490731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burbank Foot Care Center IncGroup PAC ID 8921074592, 2 clinicians

Practice addresses (Care Compare)

191 S Buena Vista St
Suite 315
Burbank, CA 91505-4556
Phone (818) 848-5586

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
85.98
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue25
Removal of skin lesions1-10
Removal of nail tissue61
Removal or shaving of skin growth89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E4797CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Burbank Foot Care Center, Inc. Foot & Ankle Surgery CurrentSince Jul 1, 2009 Accepting new patients
Providence Health System - Southern California PastSince Jul 1, 2009 Accepting new patients

Locations

191 S Buena Vista St
Ste 315
Burbank, CA 91505
Phone (818) 848-5586

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1982886412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 315",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "818-848-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 315",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "818-848-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY",
            "identifier": "1982886412",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.