DR. TAMMY KATHRYNE PARK (MD) – Emergency Medicine Physician, NPI 1043246036

DR. TAMMY KATHRYNE PARK (MD) is a healthcare provider. based in South jordan, Utah. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 5266933-1205 (UT). The NPI Number for DR. TAMMY KATHRYNE PARK (MD) is 1043246036

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
DR. TAMMY KATHRYNE PARK (MD)
NPI
1043246036
Phone
(801) 352-9500
Address
PO BOX 95970
Enumeration Date
23 June 2006
Last Update Date
28 May 2009

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
8015458100
Graduation Year
1996 (30 years ago)
PAC ID
4082764030
Group Practice PAC ID
4284548116
Professional Enrollment ID
I20090706000674
Address ID
UT840200001DR11800STXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

487 EMERGENCY MEDICINE in UT

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Provider Addresses for DR. TAMMY KATHRYNE PARK (MD)

  • South Redwood Road, West Jordan, Salt Lake County, Utah, 84088, United States

    SOUTH JORDAN, UT 840950970

    Phone: (801) 352-9500

    Fax: (801) 352-9502

    Type: Mailing

  • St. Mark's Hospital, 1200, 3900 South, Millcreek, Salt Lake County, Utah, 84124, United States

    SALT LAKE CITY, UT 841241300

    Phone: (801) 268-7975

    Fax: (801) 270-3324

    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: 2009-07-06

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
I20090706000674IEmergency MedicineUTTBD

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
99285Emergency department visit with high level of medical decision making4242$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only2927$0
99284Emergency department visit with moderate level of medical decision making2120$0
View full utilization report →

Insurance plans in this area (ZIP 84095)

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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: 4284548116View full group profile
NameSpecialtyState
Emergency MedicineAZ
Emergency MedicineUT
Emergency MedicineUT
Emergency MedicineNV
Emergency MedicineCA
Emergency MedicineGA
Emergency MedicineTX
-UT
Emergency MedicineUT
Emergency MedicineUT

Reviews

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Frequently asked questions

Does DR. TAMMY KATHRYNE PARK (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. TAMMY KATHRYNE PARK (MD) uses 1043246036.
Can I rely on DR. TAMMY KATHRYNE PARK (MD) being an active provider?
As of the registry snapshot, DR. TAMMY KATHRYNE PARK (MD) is marked active.
What is DR. TAMMY KATHRYNE PARK (MD)'s primary classification?
Emergency Medicine Physician is the headline specialty for DR. TAMMY KATHRYNE PARK (MD) here. Clinical services aligned with this taxonomy classification.
Does DR. TAMMY KATHRYNE PARK (MD) list a practice location?
Patients near South Jordan, Utah may find DR. TAMMY KATHRYNE PARK (MD) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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