ROGER TIMOTHY PARK (DO) – Family Medicine Physician, NPI 1295713444
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
956 FAMILY PRACTICE in NE
Provider Addresses for ROGER TIMOTHY PARK (DO)
2501 CAPEHART RD
OFFUTT A F B, NE 681131043
Phone: (402) 294-2056
Type: Location
2309, Marilyn Drive, Papillion, Sarpy County, Nebraska, 68046, United States
PAPILLION, NE 680464218
Phone: (402) 593-4041
Type: Mailing
4088 US-91
HYDE PARK, UT 84318
Phone: (435) 563-4900
Type: Mailing
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: 2013-08-19
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20130819000094 | I | Family Practice | UT | 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 | 67 | 65 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 28 | 28 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 24 | 23 | $0 |
| 81003 | Automated urinalysis test | 23 | 23 | $0 |
| 71046 | X-ray of chest, 2 views | 13 | 13 | $0 |
Insurance plans in this area (ZIP 68113)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | UT | |
| - | OR | |
| Diagnostic Radiology | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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