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MARY PARK MD
NPI 1891351862
Pediatrics in Elk River, MN

Active since May 15, 2019PECOS Enrolled
290 MAIN ST NW, ELK RIVER, MN 55330(855) 324-7843 Get Directions Write a Review

NPPES record last updated: July 7, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2022, May 15, 2019 (2 updates tracked since 2019).

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

NPI1891351862
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMARY PARKCredential: MD
Location Address290 MAIN ST NWElk River, MN 55330-1270
Mailing Address290 Main St NwElk River, MN 55330-1270 · (855) 324-7843
Phone(855) 324-7843
Sole ProprietorYes
Enumeration DateMay 15, 2019
Last NPPES UpdateJuly 7, 20222 updates tracked since enumeration
NPPES CertifiedMay 24, 2022
✔ NPI 1891351862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MN · 71839
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
290 MAIN ST NW, Elk River, MN 55330
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Secondary Practice Location 1

Location 12450 Riverside Ave Fl 6Minneapolis, MN 55454-1450 · Phone (612) 624-4477

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Park Md 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.

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.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

ELIZABETH MCLEAN CNP
Nurse Practitioner (Family)
290 MAIN ST NW
ELK RIVER, MN 55330
Sherburne County (763) 241-0373
KELLY VEVEA
Nurse Practitioner (Family)
290 MAIN ST NW
ELK RIVER, MN 55330
Sherburne County (612) 672-2986
FAIRVIEW CLINICS
Clinic/Center (Primary Care)
290 MAIN ST NW, STE 100
ELK RIVER, MN 55330
Sherburne County (763) 241-5800
CHERYL DENISE NELSON RPH
Pharmacist
290 MAIN ST NW
ELK RIVER, MN 55330
Sherburne County (763) 241-5890
AMY L FAIR M.D.
Pediatrics
290 MAIN ST NW, SUITE 100
ELK RIVER, MN 55330
Sherburne County (763) 241-5805
DR. AARON PINION DO
Allergy & Immunology
290 MAIN ST NW
ELK RIVER, MN 55330
Sherburne County (763) 241-5800
CASSONDRA LANE DAHLHEIMER PA-C
Physician Assistant (Medical)
290 MAIN ST NW, SUITE 100
ELK RIVER, MN 55330
Sherburne County (763) 241-0373
ALEX J SHAYKEVICH DO
Family Medicine
290 MAIN ST NW
ELK RIVER, MN 55330
Sherburne County (855) 324-7843

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.

What insurance does Mary Park accept?

Health plans from Medica and 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.