KEUM PARK
NPI 1649331505
Dentist - General Practice in Largo, FL
About Keum Park NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEUM PARK (NPI 1649331505) is an individual general practice provider in Largo, Florida, licensed in Florida (DN15469) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Keum Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Keum Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Melbourne, FL 32935
- Reassigned Medicare billing, Florida enrollment
- Medicare enrollment name: Castle 1st Dental Care P.A.
- 2 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 33771 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 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Keum Park's NPI number?
The NPI number for Keum Park is 1649331505. It was assigned to this individual provider in the NPPES registry on December 13, 2006.
Where is Keum Park located?
Keum Park practices at 10500 Ulmerton Rd Suite 210, Largo, FL 33771. The listed phone number is (727) 581-1900.
What is Keum Park's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Keum Park enrolled in Medicare?
Yes. Keum Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Keum Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keum Park reassigns Medicare benefits to Castle 1st Dental Care PA (Melbourne, FL). 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 Keum Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Keum Park accept?
Health plans from Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield, BEST Life and Blue Cross and Blue Shield of Montana and 14 other insurers list Keum Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Keum Park was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Keum Park · NPI 1649331505
General Practice provider in Largo, Florida. Individual provider, active in the CMS NPPES registry since December 13, 2006.
## Identity
- **NPI:** 1649331505 (Entity type: Individual)
- **Enumerated:** December 13, 2006
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** DN15469 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 10500 ULMERTON RD, SUITE 210, Largo, FL 33771-3544
- **Phone:** (727) 581-1900
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Castle 1st Dental Care PA (NPI 1700958956, Melbourne, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1649331505) · Data from the CMS NPPES public registry.