HEIDI M PARK (OD) – Optometrist, NPI 1710902721

HEIDI M PARK (OD) is a healthcare provider. based in Vienna, Virginia. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. 18003405 A (IN). The NPI Number for HEIDI M PARK (OD) is 1710902721

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
HEIDI M PARK (OD)
NPI
1710902721
Phone
Not provided
Address
1950 OLD GALLOWS RD STE 520
Enumeration Date
12 July 2006
Last Update Date
24 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5747734341
Graduation Year
2006 (20 years ago)
PAC ID
1658478102
Group Practice PAC ID
9830214832
Professional Enrollment ID
I20070518000124
Address ID
IN465509216NA1752XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,126 OPTOMETRY in IN

Provider Addresses for HEIDI M PARK (OD)

  • 1950 OLD GALLOWS RD STE 520

    VIENNA, VA 221823970

    Phone:

    Type: Mailing

  • 3701 S MAIN ST

    ELKHART, IN 465173106

    Phone: (574) 875-8511

    Fax: (574) 875-8763

    Type: Location

  • Residence Inn Indianapolis Fishers, 9765, Crosspoint Boulevard, Indianapolis, Hamilton County, Indiana, 46256, United States

    STE 100

    INDIANAPOLIS, IN 462563844

    Phone: (317) 254-6480

    Type: Mailing

  • 2839, Lafayette Road, Venerable Flackville, Indianapolis, Marion, Indiana, 46222, United States

    INDIANAPOLIS, IN 462222147

    Phone: (317) 924-1300

    Fax: (317) 924-1300

    Type: Location

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 $48.

Total Amount is formed as General ($48) + Research ($0) + Ownership ($0) = $48.

Last reported payment date: 2023-09-25 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($34).

Total Amount

$48

General + Research + Ownership

Payments

3

Total payment records

General Amount

$48

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2007-05-18

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
I20070518000124IOptometryINTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes1514$0
View full utilization report →

Insurance plans in this area (ZIP 22182)

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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: 9830214832View full group profile
NameSpecialtyState
O P T O M E T R YIN
-IN
O P T O M E T R YIN

Reviews

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Frequently asked questions

What is the standard ID for HEIDI M PARK (OD) in the U.S.?
In the U.S., HEIDI M PARK (OD) is identified by NPI 1710902721.
Should I treat HEIDI M PARK (OD) as an active provider?
Patients and plans typically see HEIDI M PARK (OD) as active in the national extract.
What type of care does HEIDI M PARK (OD) provide?
HEIDI M PARK (OD)'s profile centers on Optometrist. Clinical services aligned with this taxonomy classification.
Is HEIDI M PARK (OD) tied to Vienna, Virginia?
If you are local to Vienna, Virginia, HEIDI M PARK (OD) may be relevant to your search.
Who maintains HEIDI M PARK (OD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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