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BAY AREA COMPREHENSIVE SPINE AND SPORTS MEDICAL GROUP INC
NPI 1205928645
Physical Medicine & Rehabilitation - Sports Medicine in Oakland, CA

Active since September 29, 2006
5700 TELEGRAPH AVE STE 100, OAKLAND, CA 94609(510) 463-4700(510) 463-4722 Get Directions Write a Review

NPPES record last updated: October 9, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bay Area Comprehensive Spine And Sports Medical Group Inc NPPES

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

BAY AREA COMPREHENSIVE SPINE AND SPORTS MEDICAL GROUP INC (NPI 1205928645) is a healthcare organization registered as a sports medicine in Oakland, California and active in the NPI registry since September 2006. The organization lists Michael Kwansup Park, President, as its authorized official.

NPPES Registry Identity

NPI1205928645
Entity TypeOrganization
Primary Taxonomy2081S0010X
Legal Business NameBAY AREA COMPREHENSIVE SPINE AND SPORTS MEDICAL GROUP INC
Location Address5700 TELEGRAPH AVE STE 100Oakland, CA 94609-1710
Mailing Address5700 Telegraph Ave Ste 100Oakland, CA 94609-1710 · (510) 463-4700 · Fax (510) 463-4722
Phone(510) 463-4700
Fax(510) 463-4722
Organization SubpartNo
Authorized OfficialMichael Kwansup ParkPresident · (510) 463-4700
Enumeration DateSeptember 29, 2006
Last NPPES UpdateOctober 9, 2019
✔ NPI 1205928645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081S0010X
Definition
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
5700 TELEGRAPH AVE STE 100, Oakland, CA 94609
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bay Area Comprehensive Spine And Sports Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Bay Area Comprehensive Spine And Sports Medical Group Inc, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Marina Bulatov, M.D.
Physical Medicine and Rehabilitation
NPI 1932215944
1940 WEBSTER ST STE 200
Oakland, CA 94612
(510) 463-4700
✔ PECOS2.5 mi
Michael Park, MD
Physical Medicine and Rehabilitation
NPI 1932289030
1940 WEBSTER ST 2ND FLOOR
Oakland, CA 94612
(510) 463-4700
✔ PECOS✔ Accepts Medicare2.5 mi

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

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 Bay Area Comprehensive Spine And Sports Medical Group Inc's NPI number?

The NPI number for Bay Area Comprehensive Spine And Sports Medical Group Inc is 1205928645. It was assigned to this organization in the NPPES registry on September 29, 2006.

Where is Bay Area Comprehensive Spine And Sports Medical Group Inc located?

Bay Area Comprehensive Spine And Sports Medical Group Inc is located at 5700 Telegraph Ave Ste 100, Oakland, CA 94609. The listed phone number is (510) 463-4700.

What is Bay Area Comprehensive Spine And Sports Medical Group Inc's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Is Bay Area Comprehensive Spine And Sports Medical Group Inc enrolled in Medicare?

Yes. Bay Area Comprehensive Spine And Sports Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bay Area Comprehensive Spine And Sports Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Medicine and Rehabilitation, reassign their Medicare billing to Bay Area Comprehensive Spine And Sports Medical Group Inc. A 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 the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bay Area Comprehensive Spine And Sports Medical Group Inc was last updated on October 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.