Mr Kevin Alan Park, OTR/L, CHT is a medicare enrolled "Occupational Therapist" provider in New Albany, Mississippi. He graduated from medical school in 1994 and has 30 years of diverse experience with area of expertise as Occupational Therapy. He is a member of the group practice Athletico Ltd and his current practice location is
206b Oxford Rd, New Albany, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 534-4445.
Mr Kevin Alan Park is licensed to practice in Mississippi (license number OT0359) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215004965.
Healthcare Provider's Profile
| Full Name | Mr Kevin Alan Park |
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| Gender | Male |
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| Speciality | Occupational Therapy |
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| Experience | 30 Years |
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| Location | 206b Oxford Rd, New Albany, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Kevin Alan Park graduated from medical school in 1994
NPI Data:
- NPI Number: 1215004965
- Provider Enumeration Date: 11/29/2006
- Last Update Date: 03/26/2009
Medicare PECOS Information:
- PECOS PAC ID: 7113090481
- Enrollment ID: I20220526002631
Medical Identifiers
Medical identifiers for Mr Kevin Alan Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215004965 | NPI | - | NPPES |
| 582681044 | Other | MS | TAX ID |
| 06957897 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | OT0359 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Athletico Ltd | 4789602681 | 1957 |
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. Mr Kevin Alan Park allows following entities to bill medicare on his behalf.
| Provider Name | Athletico Ltd |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1477224814
PECOS PAC ID: 4789602681
Enrollment ID: O20211115001046 |
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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. Mr Kevin Alan 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 |
|---|
Mr Kevin Alan Park, OTR/L, CHT
206b Oxford Rd,
New Albany, MS 38652-3115
Ph: (662) 534-4445 | Mr Kevin Alan Park, OTR/L, CHT
206b Oxford Rd,
New Albany, MS 38652-3115
Ph: (662) 534-4445 |
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