KENNETH PARK PA-C
NPI 1194973768
Physician Assistant in Chicago, IL
About Kenneth Park Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENNETH PARK PA-C (NPI 1194973768) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085003022) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS, is affiliated with Mt Sinai Hospital Medical Center, and is a graduate of Other (2007).
NPPES Registry Identity
Specialties & Licenses
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
Kenneth Park Pa-c 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mt Sinai Hospital Medical Center
Acute Care Hospitals · Chicago, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60623 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Kenneth Park's NPI number?
The NPI number for Kenneth Park is 1194973768. It was assigned to this individual provider in the NPPES registry on September 8, 2008.
Where is Kenneth Park located?
Kenneth Park practices at 3860 W Ogden Ave, Chicago, IL 60623. The listed phone number is (872) 588-3000.
What is Kenneth Park's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Kenneth Park enrolled in Medicare?
Yes. Kenneth 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.
Is Kenneth Park affiliated with any hospitals?
According to CMS data, Kenneth Park is affiliated with Mt Sinai Hospital Medical Center.
When was this NPI record last updated?
The NPPES record for Kenneth Park was last updated on August 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Kenneth Park, PA-C · NPI 1194973768
Physician Assistant physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since September 8, 2008.
## Identity
- **NPI:** 1194973768 (Entity type: Individual)
- **Enumerated:** September 8, 2008
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 085003022 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 3860 W OGDEN AVE, Chicago, IL 60623-2460
- **Phone:** (872) 588-3000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2007
## Record status
- **NPPES last updated:** August 31, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1194973768) · Data from the CMS NPPES public registry.