DAI PARK (M.D.) – Allergy & Immunology Physician, NPI 1376744896

DAI PARK (M.D.) is a healthcare provider. based in Modesto, California. specializing in ALLERGY/IMMUNOLOGY, INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. 45278 (TN). The NPI Number for DAI PARK (M.D.) is 1376744896

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
DAI PARK (M.D.)
NPI
1376744896
Phone
(209) 521-6097
Address
600 COFFEE RD
Enumeration Date
31 May 2007
Last Update Date
22 December 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
5104901222
Graduation Year
2006 (20 years ago)
PAC ID
2163563875
Group Practice PAC ID
4284538778
Professional Enrollment ID
I20120820000301
Address ID
CA945382299FR3200XSTXX300
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

521 ALLERGY/IMMUNOLOGY in CA

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Provider Addresses for DAI PARK (M.D.)

  • 600, Coffee Road, Modesto, Stanislaus County, California, 95355, United States

    MODESTO, CA 953554201

    Phone: (209) 521-6097

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $218.

Total Amount is formed as General ($218) + Research ($0) + Ownership ($0) = $218.

Last reported payment date: 2024-02-05 • Largest payer in this snapshot: Genentech USA, Inc. ($86).

Total Amount

$218

General + Research + Ownership

Payments

8

Total payment records

General Amount

$218

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120820000301IAllergy/ImmunologyCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes2518$0
99204New patient office or other outpatient visit, 45-59 minutes1919$0
View full utilization report →

Insurance plans in this area (ZIP 95355)

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Provider's Procedures

DAI PARK (M.D.) performs procedures in ALLERGY/IMMUNOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ALLERGY/IMMUNOLOGYCA95117Injection of incremental dosages of allergen, 2 or more injections77372

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284538778View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
A L L E R G Y/ I M M U N O L O G YCA
-CA
Hospitalist, Obstetrics/GynecologyCA
O B S T E T R I C S/ G Y N E C O L O G YOR
-CA
-CA
-CA
-CA
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

What federal number belongs to DAI PARK (M.D.)?
The federal identifier for DAI PARK (M.D.) is NPI 1376744896.
Is DAI PARK (M.D.)'s NPI currently valid?
The extract we use shows DAI PARK (M.D.) as active.
What does DAI PARK (M.D.) treat or focus on?
Patients typically see DAI PARK (M.D.) under the specialty Allergy & Immunology Physician. Clinical services aligned with this taxonomy classification.
Where is DAI PARK (M.D.)'s primary listing?
We display Modesto, California because that is what the record indicates for DAI PARK (M.D.).
What if Modesto, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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