Kelly Park, DO in Antioch, CA - Medicare Obstetrics/gynecology

Kelly Park, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Antioch, California. She went to Touro Un College Of Osteopathic Medicine, Vallejo and graduated in 2016 and has 8 years of diverse experience with area of expertise as Obstetrics/gynecology. She is a member of the group practice Permanente Medical Group Inc and her current practice location is 4501 Sand Creek Rd, Antioch, California. You can reach out to her office (for appointments etc.) via phone at (925) 813-6500.

Kelly Park is licensed to practice in California (license number 20007) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1346536349.

Contact Information

	Kelly Park, DO
	4501 Sand Creek Rd, Antioch, CA 94531-8687
	(925) 813-6500
	Not Available

Map and Direction

Physician's Profile

Full Name	Kelly Park
Gender	Female
Speciality	Obstetrics/gynecology
Experience	8 Years
Location	4501 Sand Creek Rd, Antioch, California
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kelly Park attended and graduated from Touro Un College Of Osteopathic Medicine, Vallejo in 2016

NPI Data:

NPI Number: 1346536349
Provider Enumeration Date: 06/28/2011
Last Update Date: 01/25/2023

Medicare PECOS Information:

PECOS PAC ID: 5799102141
Enrollment ID: I20230201002339

Medical Identifiers

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

Identifier	Type	State	Issuer
1346536349	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207V00000X	Obstetrics & Gynecology	25MB10893000 (New Jersey)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
207V00000X	Obstetrics & Gynecology	20007 (California)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Permanente Medical Group Inc	8921910225	7800

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. Kelly 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. Kelly 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
Kelly Park, DO 4501 Sand Creek Rd, Antioch, CA 94531-8687 Ph: () -	Kelly Park, DO 4501 Sand Creek Rd, Antioch, CA 94531-8687 Ph: (925) 813-6500

Reviews and Comments

Obstetrics & Gynecology Doctors in Antioch, CA

Jessica Lennon, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4053 Lone Tree Way Ste 100, Antioch, CA 94531 Phone: 925-756-3400
Dr. Daniel L Zimmerman, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3737 Lone Tree Way, Antioch, CA 94509 Phone: 925-754-9223 Fax: 925-754-3945
Anahita Latorra, Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 4501 Sand Creek Rd, Antioch, CA 94531 Phone: 925-813-3400
Kyla Ai-lan Yee, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4053 Lone Tree Way, #101, Antioch, CA 94531 Phone: 925-756-3400 Fax: 925-757-0849
Mary C. Klemm, DO Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 5601 Deer Valley Rd, Antioch, CA 94531 Phone: 925-813-6500
Nicole Kathryn Shelton, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 4501 Sand Creek Rd, Antioch, CA 94531 Phone: 925-813-3400

Kelly Park, DO - Medicare Obstetrics/gynecology in Antioch, CA