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KRISTEN PARK
NPI 1174981229
Advanced Practice Midwife in Berkeley, CA

Active since February 03, 2016PECOS EnrolledAccepts Medicare Assignment
2404 DANA ST, APT B, BERKELEY, CA 94704(408) 636-8431 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 8, 2024, May 20, 2021, Feb 3, 2016 (3 updates tracked since 2016).

About Kristen Park NPPES

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

KRISTEN PARK (NPI 1174981229) is an individual advanced practice midwife in Berkeley, California, licensed in California (236164) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (2020).

NPPES Registry Identity

NPI1174981229
Entity TypeIndividualFemale
Primary Taxonomy367A00000X
Provider Legal NameKRISTEN PARK
Location Address2404 DANA ST, APT BBerkeley, CA 94704-2574
Mailing Address1100 Veterans BlvdRedwood City, CA 94063-2037
Phone(408) 636-8431
Sole ProprietorYes
Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 2020
Enumeration DateFebruary 3, 2016
Last NPPES UpdateMay 8, 20243 updates tracked since enumeration
NPPES CertifiedMay 2, 2021
✔ NPI 1174981229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367A00000X
License✔ Licensed in CA · 236164
Definition
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.
2404 DANA ST, Berkeley, CA 94704
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kristen Park 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 ID5193185908
PECOS Enrollment IDI20230712000832
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kristen Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
7.3 mi
Internal Medicine
901 NEVIN
Richmond, CA 94801
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1235226531 (510) 307-1555
Southern California Permanente Medical Group
306 mi
Health Maintenance Organization
2103 E GONZALES RD
Oxnard, CA 93036
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1275756652 (805) 650-4700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94704 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kristen Park's NPI number?

The NPI number for Kristen Park is 1174981229. It was assigned to this individual provider in the NPPES registry on February 3, 2016.

Where is Kristen Park located?

Kristen Park practices at 2404 Dana St Apt B, Berkeley, CA 94704. The listed phone number is (408) 636-8431.

What is Kristen Park's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Is Kristen Park enrolled in Medicare?

Yes. Kristen 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.

Which organizations bill Medicare for Kristen Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kristen Park reassigns Medicare benefits to 2 organizations: Permanente Medical Group Inc (Richmond, CA) and Southern California Permanente Medical Group (Oxnard, CA). Each 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 Kristen 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 Kristen Park was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.