Frederick Kim Park, MD is a medicare enrolled "Plastic Surgery" physician in Rocky Mount, North Carolina. He went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 1983 and has 41 years of diverse experience with area of expertise as Plastic And Reconstructive Surgery. He is a member of the group practice Wilmington Dermatology Center Pllc, Park Plastic Surgery Pa, James River Dermatology Pllc and his current practice location is
4008 Capital Drive, Rocky Mount, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(252) 937-5003.
Frederick Kim Park is licensed to practice in North Carolina (license number 36793) 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 1407964547.
Physician's Profile
| Full Name | Frederick Kim Park |
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| Gender | Male |
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| Speciality | Plastic And Reconstructive Surgery |
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| Experience | 41 Years |
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| Location | 4008 Capital Drive, Rocky Mount, North Carolina |
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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:
- Frederick Kim Park attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 1983
NPI Data:
- NPI Number: 1407964547
- Provider Enumeration Date: 08/28/2006
- Last Update Date: 02/18/2016
Medicare PECOS Information:
- PECOS PAC ID: 2062488430
- Enrollment ID: I20040911000250
Medical Identifiers
Medical identifiers for Frederick Kim Park such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407964547 | NPI | - | NPPES |
| 65228 | Other | NC | BCBS |
| 7965228 | Medicaid | NC | |
| P00159404 | Other | NC | RAILROAD MEDICARE |
| DC2876 | Other | NC | MEDICARE RAILROAD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208200000X | Plastic Surgery | 36793 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Wilmington Dermatology Center Pllc | 0042385627 | 7 |
| Park Plastic Surgery Pa | 3173599545 | 2 |
| James River Dermatology Pllc | 1759430457 | 8 |
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. Frederick Kim Park allows following entities to bill medicare on his behalf.
| Entity Name | Park Plastic Surgery Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1265533806
PECOS PAC ID: 3173599545
Enrollment ID: O20040907001243 |
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| Entity Name | Wilmington Dermatology Center Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750537858
PECOS PAC ID: 0042385627
Enrollment ID: O20080815000446 |
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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. Frederick Kim 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 |
|---|
Frederick Kim Park, MD
4008 Capital Drive,
Rocky Mount, NC 27804
Ph: (252) 937-5003 | Frederick Kim Park, MD
4008 Capital Drive,
Rocky Mount, NC 27804
Ph: (252) 937-5003 |
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