HEATHER PENNELL PARK (M.D.) – Vascular Surgery Physician, NPI 1851510119
Vascular Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
218 VASCULAR SURGERY in GA
Provider Addresses for HEATHER PENNELL PARK (M.D.)
119 AMBULANCE DR
SUITE 202
CARROLLTON, GA 301173857
Phone: (770) 838-8710
Type: Mailing
157 CLINIC AVE
SUITE 302
CARROLLTON, GA 301174454
Phone: (770) 812-5902
Fax: (770) 812-5903
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2023-11-20 • Largest payer in this snapshot: LeMaitre Vascular, Inc. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| LeMaitre Vascular, Inc. | $16 |
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: 2012-08-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120803000666 | I | Vascular Surgery | GA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 127 | 99 | $0 |
| 93922 | Ultrasound study of arm and leg arteries | 83 | 79 | $0 |
| 93880 | Ultrasound of both sides of head and neck blood flow | 78 | 76 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 62 | 49 | $0 |
| 93970 | Ultrasound study of arm or leg veins with compression and maneuvers | 45 | 44 | $0 |
Insurance plans in this area (ZIP 30117)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| VASCULAR SURGERY | GA | 93926 | Ultrasound study of arteries and arterial grafts of one leg or limited | 52 | 39 |
| VASCULAR SURGERY | GA | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 25 | 21 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | TN | |
| O T O L A R Y N G O L O G Y | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| O T O L A R Y N G O L O G Y | GA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| Internal Medicine, Interventional Cardiology, Cardiovascular Disease (Cardiology) | GA | |
| Infectious Disease | GA | |
| U R O L O G Y | GA | |
| - | GA |
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