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DR. DANIEL BORAM PARK M.D.
NPI 1730317397
Pediatrics - Pediatric Emergency Medicine in Charleston, SC

Active since June 22, 2009PECOS Enrolled
171 ASHLEY AVE, CHARLESTON, SC 29425(843) 792-1414 Get Directions Write a Review

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

About Dr. Daniel Boram Park M.d. NPPES

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

DR. DANIEL BORAM PARK M.D. (NPI 1730317397) is an individual pediatric emergency medicine provider in Charleston, South Carolina, licensed in South Carolina (34501) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1730317397
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameDR. DANIEL BORAM PARKCredential: M.D.
Location Address171 ASHLEY AVECharleston, SC 29425-8908
Mailing AddressPo Box 751461Charlotte, NC 28275-1461 · (843) 792-6200
Phone(843) 792-1414
Sole ProprietorNo
Enumeration DateJune 22, 2009
Last NPPES UpdateJanuary 18, 2017
✔ NPI 1730317397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License✔ Licensed in SC · 34501
Definition
A pediatrician who has special qualifications to manage emergencies in infants and children.
Also ListedPediatricsTaxonomy 208000000X · License 34501 (SC)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
171 ASHLEY AVE, Charleston, SC 29425
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Daniel Boram 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 Daniel Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of North Carolina At Chapel Hill
221 mi
Anesthesiology
101 MANNING DR
Chapel Hill, NC 27514
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,797 clinicians in this Medicare group
NPI 1780669200 (984) 974-1000

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 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN REED WORD M.D.
Allergy & Immunology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
CHRISTOPHER ARNOLD HENSLEY CRNA
Nurse Anesthetist, Certified Registered
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
ANGELINA INDIRA PHILLIPS
Pathology (Anatomic Pathology)
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
BLAKE DANIEL FORCINA
Ophthalmology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
CHELSEA LEE CRUISE SW
Social Worker
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
DR. RICHARD HAYDEN JONES MD
Radiology (Pediatric Radiology)
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
LINDSEY HENDRICKSON NP
Nurse Practitioner
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414
MICHAEL DAMASO DE GUZMAN
Ophthalmology
171 ASHLEY AVE
CHARLESTON, SC 29425
Charleston County (843) 792-1414

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 Daniel Park's NPI number?

The NPI number for Daniel Park is 1730317397. It was assigned to this individual provider in the NPPES registry on June 22, 2009.

Where is Daniel Park located?

Daniel Park practices at 171 Ashley Ave, Charleston, SC 29425. The listed phone number is (843) 792-1414.

What is Daniel Park's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Daniel Park enrolled in Medicare?

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

Which organization bills Medicare for Daniel Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Park reassigns Medicare benefits to University Of North Carolina At Chapel Hill (Chapel Hill, NC). 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 Daniel Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Park accept?

Health plans from Blue Cross and Blue Shield of NC list Daniel 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 Daniel Park was last updated on January 18, 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.