Kelly Park, MD - Medicare Psychiatry & Neurology in West Haven, CT

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Kelly Park, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in West Haven, Connecticut. Her current practice location is 950 Campbell Ave # 11a, West Haven, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 932-5711.

Kelly Park is licensed to practice in Connecticut (license number 73887) 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 1669934659.

Contact Information

Kelly Park, MD
950 Campbell Ave # 11a,
West Haven, CT 06516-2770
(203) 932-5711
Not Available

Map and Direction




Physician's Profile

Full NameKelly Park
GenderFemale
SpecialityPsychiatry & Neurology - Psychiatry
Location950 Campbell Ave # 11a, West Haven, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1669934659
  • Provider Enumeration Date: 04/01/2019
  • Last Update Date: 08/18/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 9032540521
  • Enrollment ID: I20231207001229

Medical Identifiers

Medical identifiers for Kelly Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669934659NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2084P0800XPsychiatry & Neurology - Psychiatry 73887 (Connecticut)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. Kelly Park allows following entities to bill medicare on her behalf.
Entity NameYale University
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205822236
PECOS PAC ID: 9436061736
Enrollment ID: O20031105000015

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 AddressPractice Location Address
Kelly Park, MD
2527 Farview Rd,
Fullerton, CA 92833-1519

Ph: () -		Kelly Park, MD
950 Campbell Ave # 11a,
West Haven, CT 06516-2770

Ph: (203) 932-5711

Reviews and Comments


Psychiatry & Neurology Doctors in West Haven, CT

Dr. Robert Alan Rosenheck, MD
Psychiatry & Neurology
Medicare: Not Enrolled in Medicare
Practice Location: 950 Campbell Ave., West Haven, CT 06516
Phone: 203-937-3850    Fax: 203-937-3433
Dr. Kathleen Louise Broad, M.D.
Psychiatry & Neurology
Medicare: Not Enrolled in Medicare
Practice Location: 950 Campbell Ave, Room 151d, West Haven, CT 06516
Phone: 203-932-5711    
Dr. Eric Dietrich Hermes, M.D.
Psychiatry & Neurology
Medicare: Not Enrolled in Medicare
Practice Location: 950 Campbell Ave # 151d, Bldg. 35 (lower Level), West Haven, CT 06516
Phone: 203-930-5711    
Juan Joseph Young, M.D.
Psychiatry & Neurology
Medicare: May Accept Medicare Assignments
Practice Location: 950 Campbell Ave, West Haven, CT 06516
Phone: 203-932-5711    
Dr. Kishorchandra R Gonsai, MD
Psychiatry & Neurology
Medicare: Medicare Enrolled
Practice Location: 950 Campbell Ave, Bulding # 36, West Haven, CT 06516
Phone: 203-932-5711    Fax: 203-937-3478
Dr. Hamada Hamid Altalib, D.O.,M.P.H.
Psychiatry & Neurology
Medicare: Accepting Medicare Assignments
Practice Location: 950 Campbell Ave, Neurology-125, West Haven, CT 06516
Phone: 203-937-4724    
Dr. Mohini Ranganathan, M.D.
Psychiatry & Neurology
Medicare: Not Enrolled in Medicare
Practice Location: 950 Campbell Ave, Psychiatry Service/116a, West Haven, CT 06516
Phone: 203-932-5711    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.