Carolyn Park, DO in Fresno, CA - Medicare Pediatrics

Carolyn Park, DO is a medicare enrolled "Pediatrics" physician in Fresno, California. Her current practice location is 7300 N Fresno St, Fresno, California. You can reach out to her office (for appointments etc.) via phone at (559) 448-4500.

Carolyn Park is licensed to practice in California (license number 20A22391) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1154907830.

Contact Information

	Carolyn Park, DO
	7300 N Fresno St, Fresno, CA 93720-2941
	(559) 448-4500
	Not Available

Map and Direction

Physician's Profile

Full Name	Carolyn Park
Gender	Female
Speciality	Pediatrics
Location	7300 N Fresno St, Fresno, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154907830
Provider Enumeration Date: 03/22/2021
Last Update Date: 07/14/2025

Medicare PECOS Information:

PECOS PAC ID: 2163953332
Enrollment ID: I20240930002250

Medical Identifiers

Medical identifiers for Carolyn Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154907830	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	20A22391 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carolyn Park allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carolyn Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Carolyn Park, DO 7300 N Fresno St, Fresno, CA 93720-2941 Ph: () -	Carolyn Park, DO 7300 N Fresno St, Fresno, CA 93720-2941 Ph: (559) 448-4500

Reviews and Comments

Pediatrics Doctors in Fresno, CA

Wilfred Derksen, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1570 E Herndon Ave, Fresno, CA 93720 Phone: 559-437-7300 Fax: 559-437-7153
Dr. Jean Rankin Butterfield, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2719 N Air Fresno Dr, Fresno, CA 93727 Phone: 559-600-8918
Dr. Mary A Gonzalez-howard, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4770 W Herndon Ave, Suite 108, Fresno, CA 93722 Phone: 559-256-7990 Fax: 559-256-7991
Nilufer Raj Goyal-shockley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 7300 N Fresno St, Fresno, CA 93720 Phone: 559-448-4500
Dr. Nitika Narinder Dhir, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 155 N Fresno St, Ste 326, Fresno, CA 93701 Phone: 559-499-6466
Denise Der Knudson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4785 N 1st St, Fresno, CA 93726 Phone: 559-448-4894
Reem Aboushaar, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2823 Fresno St, Fresno, CA 93721 Phone: 559-443-2682 Fax: 559-443-2681

Carolyn Park, DO - Medicare Pediatrics in Fresno, CA