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PETER J PARK MD
NPI 1245026764
Student in an Organized Health Care Education/Training Program in Aurora, CO

Active since April 21, 2025PECOS Enrolled
1890 N REVERE CT # F546, AURORA, CO 80045(303) 724-6019 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Peter J Park Md NPPES

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

PETER J PARK MD (NPI 1245026764) is an individual student in an organized health care education/training program in Aurora, Colorado and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245026764
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NamePETER J PARKCredential: MD
Location Address1890 N REVERE CT # F546Aurora, CO 80045-7464
Mailing Address1890 N Revere Ct # F546Aurora, CO 80045-7464 · (303) 724-6019
Phone(303) 724-6019
Sole ProprietorNo
Enumeration DateApril 21, 2025
NPPES CertifiedApril 19, 2025
✔ NPI 1245026764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1890 N REVERE CT # F546, Aurora, CO 80045
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peter J Park Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

SARA WAEL YOUSSEF MD
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6018
SIMON LONGHI MD
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6018
ALEXANDRA ILANA NAIDES MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019
HASHEM HANI ANABTAWI MD
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019
EDGAR I ALANIZ-CANTU MD
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019
LILLIBETH CAROLE SNELLMAN
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019
GREGORY EMERSON WYKOFF MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019
MICHAEL JAMES FRANKLIN JR.
Student in an Organized Health Care Education/Training Program
1890 N REVERE CT # F546
AURORA, CO 80045
Adams County (303) 724-6019

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 Peter Park's NPI number?

The NPI number for Peter Park is 1245026764. It was assigned to this individual provider in the NPPES registry on April 21, 2025.

Where is Peter Park located?

Peter Park practices at 1890 N Revere Ct # F546, Aurora, CO 80045. The listed phone number is (303) 724-6019.

What is Peter Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Peter Park enrolled in Medicare?

Yes. Peter Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Peter Park was last updated on April 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.