Katherine Park, CNM is a medicare enrolled "Advanced Practice Midwife" in Mount Laurel, New Jersey. Her current practice location is
210 Ark Rd Ste 216, Mount Laurel, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(856) 778-2060.
Katherine Park is licensed to practice in New Jersey (license number 25ME00063900) 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 1558861401.
Provider's Profile
Full Name | Katherine Park |
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Gender | Female |
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Speciality | Advanced Practice Midwife |
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Location | 210 Ark Rd Ste 216, Mount Laurel, New Jersey |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1558861401
- Provider Enumeration Date: 02/17/2018
- Last Update Date: 03/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 8426311895
- Enrollment ID: I20180417002321
Medical Identifiers
Medical identifiers for Katherine Park such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1558861401 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
367A00000X | Advanced Practice Midwife | 25ME00063901 (New Jersey) | Secondary |
367A00000X | Advanced Practice Midwife | 25ME00063900 (New Jersey) | 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. Katherine Park allows following entities to bill medicare on her behalf.
Entity Name | Advocare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770538696 PECOS PAC ID: 3678562188 Enrollment ID: O20040510001217 |
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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. Katherine 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 |
Katherine Park, CNM 3100 Woodhaven Dr, Cinnaminson, NJ 08077-4437 Ph: (856) 904-7082 | Katherine Park, CNM 210 Ark Rd Ste 216, Mount Laurel, NJ 08054-3188 Ph: (856) 778-2060 |
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