MARY PARK MD
NPI 1891351862
Pediatrics in Elk River, MN
About Mary Park Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY PARK MD (NPI 1891351862) is an individual pediatrics provider in Elk River, Minnesota, licensed in Minnesota (71839) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Minneapolis.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
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)
Mary Park Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Mary Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Elk River, MN 55330
- Reassigned Medicare billing, Minnesota enrollment
- 2,302 clinicians in this Medicare group
Princeton, MN 55371
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 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 55330 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.
ELK RIVER, MN 55330
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 Mary Park's NPI number?
The NPI number for Mary Park is 1891351862. It was assigned to this individual provider in the NPPES registry on May 15, 2019.
Where is Mary Park located?
Mary Park practices at 290 Main St NW, Elk River, MN 55330. The listed phone number is (855) 324-7843.
What is Mary Park's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Mary Park enrolled in Medicare?
Yes. Mary Park is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mary Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Park reassigns Medicare benefits to 2 organizations: Fairview Clinics (Elk River, MN) and Fairview Health Services (Princeton, MN). Each 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 Mary Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Park accept?
Health plans from Sanford Health Plan list Mary 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 Mary Park was last updated on July 7, 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.
# Mary Park, MD · NPI 1891351862
Pediatrics physician in Elk River, Minnesota. Individual provider, active in the CMS NPPES registry since May 15, 2019.
## Identity
- **NPI:** 1891351862 (Entity type: Individual)
- **Enumerated:** May 15, 2019
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 71839 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 290 MAIN ST NW, Elk River, MN 55330-1270
- **Phone:** (855) 324-7843
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Fairview Clinics (NPI 1144474305, Elk River, MN); Fairview Health Services (NPI 1013097377, Princeton, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 7, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1891351862) · Data from the CMS NPPES public registry.