KIMBERLY PARK MD
NPI 1124760814
Emergency Medicine in Loma Linda, CA

Active since April 12, 2022PECOS EnrolledAccepts Medicare Assignment
11234 ANDERSON ST, LOMA LINDA, CA 92354(909) 558-4085 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 1, 2025, Apr 12, 2022 (2 updates tracked since 2022).

About Kimberly Park Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY PARK MD (NPI 1124760814) is an individual emergency medicine provider in Loma Linda, California, licensed in California (A191049) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1124760814
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameKIMBERLY PARKCredential: MD
Location Address11234 ANDERSON STLoma Linda, CA 92354-2804
Mailing Address11234 Anderson St Ste CLoma Linda, CA 92354-2804 · (909) 558-4085
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateApril 12, 2022
Last NPPES UpdateJuly 1, 20252 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
NPI 1124760814 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in CA · A191049
Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

11234 ANDERSON ST, Loma Linda, CA 92354

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kimberly Park Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123531241
PECOS Enrollment IDI20250701004745
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Physician Assistant (Surgical)
11234 ANDERSON ST, RM 2562B
LOMA LINDA, CA 92354
Pediatrics (Pediatric Emergency Medicine)
11234 ANDERSON ST, A 108
LOMA LINDA, CA 92354
Radiology (Radiation Oncology)
11234 ANDERSON ST, SUITE B-121
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST, MC 5700H
LOMA LINDA, CA 92354
Internal Medicine (Cardiovascular Disease)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner
11234 ANDERSON ST, ROOM 6700H
LOMA LINDA, CA 92354
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354

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 Kimberly Park's NPI number?

The NPI number for Kimberly Park is 1124760814. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Kimberly Park located?

Kimberly Park practices at 11234 Anderson St, Loma Linda, CA 92354. The listed phone number is (909) 558-4085.

What is Kimberly Park's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Kimberly Park enrolled in Medicare?

Yes. Kimberly Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Kimberly Park was last updated on July 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.