DR. ROBERT PHIL PARK PSY.D.
NPI 1053472605
Psychologist in Stockton, CA
About Dr. Robert Phil Park Psy.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ROBERT PHIL PARK PSY.D. (NPI 1053472605) is an individual psychologist in Stockton, California, licensed in California (PSY20153) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Robert Phil Park Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Robert Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Robert Park's NPI number?
The NPI number for Robert Park is 1053472605. It was assigned to this individual provider in the NPPES registry on December 13, 2006.
Where is Robert Park located?
Robert Park practices at 1305 Tommydon St, Stockton, CA 95210. The listed phone number is (209) 476-5211.
What is Robert Park's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Robert Park enrolled in Medicare?
Yes. Robert Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Robert Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Robert Park reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Robert Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Robert Park was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.