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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KATHRYN PARK MD
NPI 1457000986
Ophthalmology in Mission Hills, CA

Active since March 22, 2022PECOS Enrolled
11333 SEPULVEDA BLVD, MISSION HILLS, CA 91345(818) 365-9531 Get Directions Write a Review

NPPES record last updated: September 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kathryn Park Md NPPES

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

KATHRYN PARK MD (NPI 1457000986) is an individual ophthalmology provider in Mission Hills, California, licensed in California (A208833) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457000986
Entity TypeIndividualFemale
Primary Taxonomy207W00000X
Provider Legal NameKATHRYN PARKCredential: MD
Location Address11333 SEPULVEDA BLVDMission Hills, CA 91345-1116
Mailing Address402 Euclid StSanta Monica, CA 90402-2128
Phone(818) 365-9531
Sole ProprietorNo
Enumeration DateMarch 22, 2022
Last NPPES UpdateSeptember 10, 2026
NPPES CertifiedSeptember 10, 2026
✔ NPI 1457000986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in CA · A208833
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
11333 SEPULVEDA BLVD, Mission Hills, CA 91345
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathryn 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.

Medicare Billing Reassignment

Medicare enrollment records show Kathryn Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Providence Facey Medical Foundation
11 mi
Internal Medicine
26357 MCBEAN PKWY
Valencia, CA 91355
  • Reassigned Medicare billing, California enrollment
  • 684 clinicians in this Medicare group
NPI 1710031588 (661) 222-2600

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91345 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SARTHI RAKSHEN SHAH M.D.
Internal Medicine
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531
ARMIN TAHOORI M.D.
Hospitalist
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531
DR. HENIE FIALKOFF M.D.
Pediatrics
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 869-7200
JENNIFER ANN SHIELDS RPT.
Physical Therapist
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531
SIMON DARDASHTI M.D.
Anesthesiology
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 869-7726
ROHIT R KEDIA D.O.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531
TRICIA A SCHREINER-DUNCAN P.A.
Physician Assistant
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531
SOURABH SURYADEVARA M.D.
Internal Medicine
11333 SEPULVEDA BLVD
MISSION HILLS, CA 91345
Los Angeles County (818) 365-9531

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 Kathryn Park's NPI number?

The NPI number for Kathryn Park is 1457000986. It was assigned to this individual provider in the NPPES registry on March 22, 2022.

Where is Kathryn Park located?

Kathryn Park practices at 11333 Sepulveda Blvd, Mission Hills, CA 91345. The listed phone number is (818) 365-9531.

What is Kathryn Park's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Kathryn Park enrolled in Medicare?

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

Which organization bills Medicare for Kathryn Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kathryn Park reassigns Medicare benefits to Providence Facey Medical Foundation (Valencia, CA). 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 Kathryn Park'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 Kathryn Park was last updated on September 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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.