DR. KENNETH PARKER JR. PHD
NPI 1417132275
Psychologist in San Jose, CA
About Dr. Kenneth Parker Jr. Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KENNETH PARKER JR. PHD (NPI 1417132275) is an individual psychologist in San Jose, California, licensed in California (PSY9141) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1981).
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
Dr. Kenneth Parker Jr. Phd 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 Reassignments
2Medicare enrollment records show Kenneth Parker reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 45 clinicians in this Medicare group
Santa Clara, CA 95054
- Reassigned Medicare billing, California enrollment
- 1,607 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.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN JOSE, CA 95110
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 Parker's NPI number?
The NPI number for Kenneth Parker is 1417132275. It was assigned to this individual provider in the NPPES registry on December 28, 2007.
Where is Kenneth Parker located?
Kenneth Parker practices at 441 Park Ave 2nd Floor, San Jose, CA 95110. The listed phone number is (408) 287-2640.
What is Kenneth Parker's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Kenneth Parker enrolled in Medicare?
Yes. Kenneth Parker 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 Kenneth Parker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Parker reassigns Medicare benefits to 2 organizations: Shine Medical Of Ca PC (San Jose, CA) and Sud Specialty Group - Ca (Santa Clara, 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 Kenneth Parker'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 Kenneth Parker was last updated on April 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.