DAVID TAEGON PARK D.O.
NPI 1275766453
Psychiatry & Neurology - Neurology in Wynnewood, PA
About David Taegon Park D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID TAEGON PARK D.O. (NPI 1275766453) is an individual neurology provider in Wynnewood, Pennsylvania, licensed in Pennsylvania (OS017068) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS, is affiliated with Bryn Mawr Hospital, and is a graduate of Kansas City University Of Physicians And Surgeons (2009).
NPPES Registry Identity
Specialties & Licenses
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
David Taegon Park D.o. 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.
Medicare Billing Reassignment
Medicare enrollment records show David Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Newtown Square, PA 19073
- Reassigned Medicare billing, Pennsylvania enrollment
- 1,638 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 9
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bryn Mawr Hospital
Acute Care Hospitals · Bryn Mawr, PAPaoli Hospital
Acute Care Hospitals · Paoli, PAMain Line Hospital Lankenau
Acute Care Hospitals · Wynnewood, PARiddle Memorial Hospital
Acute Care Hospitals · Media, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19096 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.
WYNNEWOOD, PA 19096
WYNNEWOOD, PA 19096
WYNNEWOOD, PA 19096
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 David Park's NPI number?
The NPI number for David Park is 1275766453. It was assigned to this individual provider in the NPPES registry on September 3, 2009.
Where is David Park located?
David Park practices at 100 E Lancaster Ave Suite 256 Lankenau Mob East, Wynnewood, PA 19096. The listed phone number is (484) 572-6300.
What is David Park's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.
Is David Park enrolled in Medicare?
Yes. David 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 organization bills Medicare for David Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Park reassigns Medicare benefits to Main Line Healthcare (Newtown Square, PA). The 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 David Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is David Park affiliated with any hospitals?
According to CMS data, David Park is affiliated with Bryn Mawr Hospital, Paoli Hospital, Main Line Hospital Lankenau and Riddle Memorial Hospital.
When was this NPI record last updated?
The NPPES record for David Park was last updated on October 22, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# David Taegon Park, D.O. · NPI 1275766453
Neurology physician in Wynnewood, Pennsylvania. Individual provider, active in the CMS NPPES registry since September 3, 2009.
## Identity
- **NPI:** 1275766453 (Entity type: Individual)
- **Enumerated:** September 3, 2009
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **State license:** OS017068 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 E LANCASTER AVE, SUITE 256 LANKENAU MOB EAST, Wynnewood, PA 19096-3450
- **Phone:** (484) 572-6300 · **Fax:** (484) 572-6305
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Main Line Healthcare (NPI 1922077643, Newtown Square, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Kansas City University Of Physicians And Surgeons, class of 2009
## Record status
- **NPPES last updated:** October 22, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1275766453) · Data from the CMS NPPES public registry.