Benjamin Park, MD, PHD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone

(650) 497-5415

NPI assigned

Apr 2, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Interventional Radiology

Education

Illinois Medical College, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newport Harbor Radiology Associates Medical Group IncGroup PAC ID 1850285735, 69 clinicians

Newport Center Radiology Associates Medical Group IncGroup PAC ID 7810800166, 60 clinicians

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224
• Kaiser Foundation Hospital - Downey Hospital, Downey, CA, CCN 050139
• Hoag Orthopedic Institute Hospital, Irvine, CA, CCN 050769

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

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.

• Newport Center Radiology Associates Medical Group Inc

  • Diagnostic Radiology Physician
  • Newport Beach, CA
  • NPI 1013951714
  Medicare reassignment Care Compare group
• Newport Harbor Radiology Associates Medical Group, Inc

  • Diagnostic Radiology Physician
  • Newport Beach, CA
  • NPI 1053355792
  Medicare reassignment Care Compare group
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1043242563
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• Advanced Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Stockton, CA
  • NPI 1669123626
  NPD (past)

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

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• Hoag Orthopedic Institute LLC

  • Special Hospital
  • Irvine, CA
  • NPI 1982927877
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1518012301
  Care Compare affiliation

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1992267587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-497-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "BENJAMIN",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divya Ahuja Parikh, MD
• Victoria Nicole Parikh, MD
• Albert Park, MD
• Anna Kyunglim Park
• Annsea Park, MD, PHD
• Chul-Kyun Park, M.D.
• David Jaehyun Park, MD, PHD
• Jane Lee Park, M.D.
• Janet Christine Park
• Jennifer Moonjung Park, PHD

• Student in an Organized Health Care Education/Training Program in Stanford, CA
• Providers in Stanford, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.