Dr Haeli Park, MD in Lodi, CA - Medicare Pediatrics

Dr Haeli Park, MD is a medicare enrolled "Pediatrics" physician in Lodi, California. Her current practice location is 975 S Fairmont Ave, Lodi, California. You can reach out to her office (for appointments etc.) via phone at (209) 339-7639.

Dr Haeli Park is licensed to practice in California (license number A163831) 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 1114422631.

Contact Information

	Dr Haeli Park, MD
	975 S Fairmont Ave, Lodi, CA 95240-5118
	(209) 339-7639
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Haeli Park
Gender	Female
Speciality	Pediatrics
Location	975 S Fairmont Ave, Lodi, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114422631
Provider Enumeration Date: 03/27/2018
Last Update Date: 08/01/2021

Medicare PECOS Information:

PECOS PAC ID: 1153714191
Enrollment ID: I20220215001421

Medical Identifiers

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

Identifier	Type	State	Issuer
1114422631	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	A163831 (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. Dr Haeli Park allows following entities to bill medicare on her behalf.

Entity Name	Regents Of The Univ Of Ca
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013906973 PECOS PAC ID: 3375456619 Enrollment ID: O20031111000892

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. Dr Haeli 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
Dr Haeli Park, MD 2300 Stockton Blvd Ste 1700, Sacramento, CA 95817-2202 Ph: (209) 339-7639	Dr Haeli Park, MD 975 S Fairmont Ave, Lodi, CA 95240-5118 Ph: (209) 339-7639

Reviews and Comments

Pediatrics Doctors in Lodi, CA

Dr. Marietta Abellera Sumaquial, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2401 W Turner Rd, Suite 450, Lodi, CA 95242 Phone: 209-370-1700
Arvinder Kaur Thiara, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1300 W Lodi Ave, Suite P, Lodi, CA 95242 Phone: 209-366-1990 Fax: 209-473-9256
Lancy Lu, Pediatrics Medicare: Medicare Enrolled Practice Location: 975 S Fairmont Ave, Lodi, CA 95240 Phone: 209-339-7639
Dr. Roy Anunciacion, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1920 Tienda Dr, Ste 102, Lodi, CA 95242 Phone: 209-368-8310
Dr. Rosemary Nunez-davis, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1901 W Kettleman Ln Ste 200, Lodi, CA 95242 Phone: 209-334-8540
Abelardo Verceles Mayo, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1300 W Lodi Ave, Suite P, Lodi, CA 95242 Phone: 209-369-7493

Dr Haeli Park, MD - Medicare Pediatrics in Lodi, CA