Haeli Park, MD
NPI 1114422631 · Pediatrics Physician · Lodi, CA
Enrolled with Medicare as Practitioner - Pediatric Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Haeli Park, MD is a Pediatrics Physician provider in Lodi, CA (NPI 1114422631).
Provider details
- NPI number
- 1114422631
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- A163831 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-03-27
- Last updated
- 2021-08-01
- Certified
- 2021-08-01
Frequently asked questions
- What is Haeli Park's NPI number?
- Haeli Park's National Provider Identifier (NPI) is 1114422631, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Haeli Park's specialty?
- Haeli Park is listed in the NPPES registry with a primary specialty of Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Haeli Park located?
- Haeli Park's practice location on file with NPPES is 975 S Fairmont Ave, Lodi, CA 95240-5118.
- What is Haeli Park's phone number?
- The practice phone number listed in the NPPES registry for Haeli Park is (209) 339-7639.
- Does Haeli Park accept Medicare?
- Haeli Park is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Haeli Park's NPI active?
- Yes — Haeli Park's NPI (1114422631) is active in the NPPES registry as of the last update on 2021-08-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.