DR. DAVID J PARK (M.D.) – Family Medicine Physician, NPI 1790780211

DR. DAVID J PARK (M.D.) is a healthcare provider. based in White river junction, Vermont. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 042-0010755 (VT). The NPI Number for DR. DAVID J PARK (M.D.) is 1790780211

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. DAVID J PARK (M.D.)
NPI
1790780211
Phone
(802) 295-6132
Address
331 OLCOTT DR
Enumeration Date
21 June 2005
Last Update Date
29 March 2021

Doctor Profile

Medical School Name
JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Secondary Phone
8022956132
Graduation Year
2001 (25 years ago)
PAC ID
7113998154
Group Practice PAC ID
3971561358
Professional Enrollment ID
I20040804000092
Address ID
VT050019263WH331XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

355 FAMILY PRACTICE in VT

Provider Addresses for DR. DAVID J PARK (M.D.)

  • 331 OLCOTT DR

    STE U3

    WHITE RIVER JUNCTION, VT 050019601

    Phone: (802) 295-6132

    Fax: (802) 295-1358

    Mailing address matches the actual address.

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: 2004-08-04

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
I20040804000092IFamily PracticeVTTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes339214$0
36415Insertion of needle into vein for collection of blood sample129111$0
99213Established patient office or other outpatient visit, 20-29 minutes11397$0
G0442Annual alcohol misuse screening, 5 to 15 minutes103103$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit9898$0
View full utilization report →

Insurance plans in this area (ZIP 05001)

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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: 3971561358View full group profile
NameSpecialtyState
Hospitalist, Obstetrics/GynecologyVT
Nurse PractitionerVT
Nurse PractitionerVT
Nurse PractitionerMA
Family PracticeVT
General PracticeVT
Nurse PractitionerVT
-VT
Family PracticeVT
Family PracticeVT

Reviews

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Frequently asked questions

What is the standard ID for DR. DAVID J PARK (M.D.) in the U.S.?
In the U.S., DR. DAVID J PARK (M.D.) is identified by NPI 1790780211.
Is DR. DAVID J PARK (M.D.) currently accepting referrals based on NPI status?
Registry metadata lists DR. DAVID J PARK (M.D.) as active.
What does the directory say DR. DAVID J PARK (M.D.) does?
Insurance directories may phrase it differently, but here DR. DAVID J PARK (M.D.) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. DAVID J PARK (M.D.)?
DR. DAVID J PARK (M.D.) shows a connection to White River Junction, Vermont in registry-derived data.
Who maintains DR. DAVID J PARK (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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