Kristen Park, in Berkeley, CA - Medicare Advanced Practice Midwife

Kristen Park, is a medicare enrolled "Advanced Practice Midwife" in Berkeley, California. Her current practice location is 2404 Dana St, Apt B, Berkeley, California. You can reach out to her office (for appointments etc.) via phone at (408) 636-8431.

Kristen Park is licensed to practice in California (license number 236164) 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 1174981229.

Contact Information

	Kristen Park,
	2404 Dana St, Apt B, Berkeley, CA 94704-2574
	(408) 636-8431
	Not Available

Map and Direction

Provider's Profile

Full Name	Kristen Park
Gender	Female
Speciality	Advanced Practice Midwife
Location	2404 Dana St, Berkeley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174981229
Provider Enumeration Date: 02/03/2016
Last Update Date: 05/08/2024

Medicare PECOS Information:

PECOS PAC ID: 5193185908
Enrollment ID: I20230712000832

Medical Identifiers

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

Identifier	Type	State	Issuer
1174981229	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367A00000X	Advanced Practice Midwife	236164 (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. Kristen Park allows following entities to bill medicare on her behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

Entity Name	Southern California Permanente Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678

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. Kristen 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
Kristen Park, 1100 Veterans Blvd, Redwood City, CA 94063-2037 Ph: () -	Kristen Park, 2404 Dana St, Apt B, Berkeley, CA 94704-2574 Ph: (408) 636-8431

Reviews and Comments

Advanced Practice Midwife Nurses in Berkeley, CA

Eva L. Goodfriend-reano, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2216 Mcgee Ave, Berkeley, CA 94703 Phone: 510-848-1352 Fax: 510-323-2361
Aimee Tom, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 3010 Colby St, Berkeley, CA 94705 Phone: 510-882-2137
Ms. Sallie Peters Hill, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2450 Ashby Ave, Berkeley, CA 94705 Phone: 510-204-3977 Fax: 510-204-5429
Ms. Lauren L. Galaty, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2001 Dwight Way, Berkeley Primary Care, Room 1363, Berkeley, CA 94704 Phone: 510-204-4637
Kassandra Marie Donnels, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 2450 Ashby Ave, Berkeley, CA 94705 Phone: 510-204-4444
Mrs. Lior Mayer, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 2450 Ashby Ave, Berkeley, CA 94705 Phone: 510-204-3977 Fax: 510-204-5129

Kristen Park, - Medicare Advanced Practice Midwife in Berkeley, CA