KELLEY KATHRYN O'CONNOR PARK (DPT) – Physical Therapist, NPI 1750693115

KELLEY KATHRYN O'CONNOR PARK (DPT) is a healthcare provider. based in Palo alto, California. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. 070017799 (IL). The NPI Number for KELLEY KATHRYN O'CONNOR PARK (DPT) is 1750693115

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
KELLEY KATHRYN O'CONNOR PARK (DPT)
NPI
1750693115
Phone
(650) 331-3700
Address
454 FOREST AVE
Enumeration Date
13 July 2010
Last Update Date
14 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6693771133
Graduation Year
2006 (20 years ago)
PAC ID
6002075314
Group Practice PAC ID
7113834870
Professional Enrollment ID
I20140819000486
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:15State licenses:2Digital endpointsOther names

Provider Addresses for KELLEY KATHRYN O'CONNOR PARK (DPT)

  • 454 FOREST AVE

    PALO ALTO, CA 943012608

    Phone: (650) 331-3700

    Fax: (650) 331-3730

    Type: Mailing

  • 1099 D ST STE 105

    SAN RAFAEL, CA 949012839

    Phone: (415) 532-8335

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-08-19

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
I20140819000486IPhysical Therapist In Private PracticeCATBD

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
97530Therapy procedure using functional activities1,086212$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,010193$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes888187$0
97140Therapy procedure using manual technique, each 15 minutes742165$0
97150Therapy procedure in a group setting30690$0
View full utilization report →

Insurance plans in this area (ZIP 94301)

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Provider's Procedures

KELLEY KATHRYN O'CONNOR PARK (DPT) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCA97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes3912

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: 7113834870View full group profile

Reviews

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Frequently asked questions

Where can patients find KELLEY KATHRYN O'CONNOR PARK (DPT)'s NPI?
You can confirm KELLEY KATHRYN O'CONNOR PARK (DPT) with NPI 1750693115; it appears in the national provider directory.
Is KELLEY KATHRYN O'CONNOR PARK (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does KELLEY KATHRYN O'CONNOR PARK (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for KELLEY KATHRYN O'CONNOR PARK (DPT). Clinical services aligned with this taxonomy classification.
What location metadata exists for KELLEY KATHRYN O'CONNOR PARK (DPT)?
The page summarizes Palo Alto, California for KELLEY KATHRYN O'CONNOR PARK (DPT); expand the address list for detail.
How can I contact KELLEY KATHRYN O'CONNOR PARK (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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