KEN JONGHO PARK M.D.
NPI 1649436585
Internal Medicine - Nephrology in Salem, OR
About Ken Jongho Park M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEN JONGHO PARK M.D. (NPI 1649436585) is an individual nephrology provider in Salem, Oregon, licensed in Oregon (MD150901) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Salem Hospital, and is a graduate of Rush Medical College Of Rush University (2004).
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 and accepts Medicare assignment
Ken Jongho Park M.d. 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 Ken Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Salem, OR 97317
- Reassigned Medicare billing, Oregon and Washington enrollments
- Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
- Also billed through NPI 1871848457 (Washington)
- 3,207 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
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 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Salem Hospital
Acute Care Hospitals · Salem, ORKaiser Foundation Hospital Westside
Acute Care Hospitals · Hillsboro, ORPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97305 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.
SALEM, OR 97305
SALEM, OR 97305
SALEM, OR 97305
SALEM, OR 97305
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 Ken Park's NPI number?
The NPI number for Ken Park is 1649436585. It was assigned to this individual provider in the NPPES registry on July 30, 2008.
Where is Ken Park located?
Ken Park practices at 2400 Lancaster Dr NE, Salem, OR 97305. The listed phone number is (503) 361-5400.
What is Ken Park's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Ken Park enrolled in Medicare?
Yes. Ken 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 Ken Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ken Park reassigns Medicare benefits to South Salem Rehabilitation, LLC (Salem, OR). 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 Ken Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ken Park accept?
Health plans from Kaiser Permanente list Ken 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.
Is Ken Park affiliated with any hospitals?
According to CMS data, Ken Park is affiliated with Salem Hospital and Kaiser Foundation Hospital Westside.
When was this NPI record last updated?
The NPPES record for Ken Park was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Ken Jongho Park, M.D. · NPI 1649436585
Nephrology physician in Salem, Oregon. Individual provider, active in the CMS NPPES registry since July 30, 2008.
## Identity
- **NPI:** 1649436585 (Entity type: Individual)
- **Enumerated:** July 30, 2008
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **State license:** MD150901 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 2400 LANCASTER DR NE, Salem, OR 97305-1221
- **Phone:** (503) 361-5400
## 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:** South Salem Rehabilitation, LLC (NPI 1215071998, Salem, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Rush Medical College Of Rush University, class of 2004
## Record status
- **NPPES last updated:** February 4, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1649436585) · Data from the CMS NPPES public registry.