Lily Park, DO - Medicare Dermatology in Modesto, CA

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Lily Park, DO is a medicare enrolled "Dermatology" physician in Modesto, California. Her current practice location is 600 Coffee Rd, Modesto, California. You can reach out to her office (for appointments etc.) via phone at (209) 521-6097.

Lily Park is licensed to practice in California (license number 12765) 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 1124333455.

Contact Information

Lily Park, DO
600 Coffee Rd,
Modesto, CA 95355-4201
(209) 521-6097
Not Available

Map and Direction




Physician's Profile

Full NameLily Park
GenderFemale
SpecialityDermatology
Location600 Coffee Rd, Modesto, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124333455
  • Provider Enumeration Date: 08/11/2010
  • Last Update Date: 08/08/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 1557590056
  • Enrollment ID: I20140203001252

Medical Identifiers

Medical identifiers for Lily Park such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124333455NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 20A12765 (California)Secondary
207R00000XInternal Medicine 5101018747 (Michigan)Secondary
207R00000XInternal Medicine DO184048 (Oregon)Secondary
208M00000XHospitalist 20A12765 (California)Secondary
207N00000XDermatology 12765 (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. Lily Park allows following entities to bill medicare on her behalf.
Entity NameSutter Valley Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669846986
PECOS PAC ID: 9830094515
Enrollment ID: O20090311000335
Entity NameBerman Skin Institute Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528175528
PECOS PAC ID: 0042407215
Enrollment ID: O20101214000672

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. Lily 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
Lily Park, DO
3105 Cedar Ravine Rd, Ste 201,
Placerville, CA 95667-6561

Ph: (530) 626-1602		Lily Park, DO
600 Coffee Rd,
Modesto, CA 95355-4201

Ph: (209) 521-6097

Reviews and Comments


Dermatology Doctors in Modesto, CA

Mr. Blake Daniel Alexander, M.D.
Dermatology
Medicare: Medicare Enrolled
Practice Location: 1101 Standiford Ave, Suite A-3, Modesto, CA 95350
Phone: 209-578-5072    Fax: 209-578-5292
Dr. Shirley Lynne Van, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1429 College Ave, Suite B, Modesto, CA 95350
Phone: 209-526-2242    
Thomas G Salopek, MD
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 600 Coffee Rd, Modesto, CA 95355
Phone: 209-524-1211    
Dr. Daniel Jerome Trozak, M.D.
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 1444 Florida Ave, Ste 201, Modesto, CA 95350
Phone: 209-526-4384    
Dr. Purita Z Villanueva, MD
Dermatology
Medicare: May Accept Medicare Assignments
Practice Location: 609 E Orangeburg Ave, Suite 201, Modesto, CA 95350
Phone: 209-572-3224    Fax: 209-572-4528
Gary Wagner, M.D.
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 600 Coffee Rd, Modesto, CA 95355
Phone: 209-524-1211    
Kinston Cummings,
Dermatology
Medicare: Medicare Enrolled
Practice Location: 3105 Mchenry Ave Ste 101, Modesto, CA 95350
Phone: 209-575-2700    

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).

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