GRACE LEE PARK M.D.
NPI 1619147592
Family Medicine in Urbana, IL

Q: What is Grace Park's NPI number?

The NPI number for Grace Park is 1619147592. It was assigned to this individual provider in the NPPES registry on March 6, 2008.

Q: What is Grace Park's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Grace Park was last updated on October 10, 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.

Active since March 06, 2008PECOS Enrolled

1109 S. LINCOLN AVE., MCKINLEY HEALTH CENTER, URBANA, IL 61801(217) 333-2711 Get Directions Write a Review

NPPES record last updated: October 10, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Grace Lee Park M.d. NPPES

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

GRACE LEE PARK M.D. (NPI 1619147592) is an individual family medicine provider in Urbana, Illinois, licensed in Illinois (036119920) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619147592

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameGRACE LEE PARKCredential: M.D.

Location Address1109 S. LINCOLN AVE., MCKINLEY HEALTH CENTERUrbana, IL 61801

Mailing Address1109 S. Lincoln Ave., Mckinley Health CenterUrbana, IL 61801 · (217) 333-2711

Phone(217) 333-2711

Sole ProprietorNo

Enumeration DateMarch 6, 2008

Last NPPES UpdateOctober 10, 2017

✔ NPI 1619147592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036119920

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1109 S. LINCOLN AVE., Urbana, IL 61801

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Other Identifiers 2

Medicare NSC6447860004IL

Medicare PINIL3270156IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace Lee Park M.d. 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 Grace Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Promise Healthcare Nfp

0.6 mi

Federally Qualified Health Center (FQHC)

1002 S RACE ST
Urbana, IL 61801

Reassigned Medicare billing, Illinois enrollment
48 clinicians in this Medicare group

NPI 1952894180 (217) 239-4220

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 61801 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Grace Park's NPI number?

The NPI number for Grace Park is 1619147592. It was assigned to this individual provider in the NPPES registry on March 6, 2008.

Where is Grace Park located?

Grace Park practices at 1109 S. Lincoln Ave. Mckinley Health Center, Urbana, IL 61801. The listed phone number is (217) 333-2711.

What is Grace Park's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Grace Park enrolled in Medicare?

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

Which organization bills Medicare for Grace Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Grace Park reassigns Medicare benefits to Promise Healthcare Nfp (Urbana, IL). 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 Grace 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 Grace Park was last updated on October 10, 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.