STEPHANIE PARK (M.D.) – Allergy & Immunology Physician, NPI 1497838387
Allergy & Immunology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
115 ALLERGY/IMMUNOLOGY in MO
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Provider Addresses for STEPHANIE PARK (M.D.)
Woodlake, Chesterfield County, Virginia, 23112, United States
SUITE 201
CHESTERFIELD, MO 630175740
Phone: (314) 878-2788
Fax: (314) 878-8988
Type: Location
6624, Waterman Avenue, Ames Place, St. Louis, Saint Louis County, Missouri, 63130, United States
SAINT LOUIS, MO 631304659
Phone: (314) 863-3532
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $69.
Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Pharming Healthcare, Inc. ($52).
Total Amount
$69
General + Research + Ownership
Payments
3
Total payment records
General Amount
$69
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Pharming Healthcare, Inc. | $52 |
| PFIZER INC. | $17 |
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: 2009-03-11
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 |
|---|---|---|---|---|
| I20090311000445 | I | Allergy/Immunology | MO | 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 |
|---|---|---|---|---|
| 95004 | Test for allergy using allergenic extract | 942 | 19 | $0 |
| 95165 | Professional service for preparation and provision of 1 or more antigens | 714 | 25 | $0 |
| 95117 | Professional service for multiple injections of allergen | 257 | 27 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 56 | 40 | $0 |
| 96160 | Administration and interpretation of patient-focused health risk assessment | 39 | 27 | $0 |
Insurance plans in this area (ZIP 63017)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Allergy/Immunology, Pediatric Medicine | MO | |
| Physician Assistant | IL | |
| - | MO |
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