Lily Park, D.O.

NPI 1124333455ActiveIndividual· Dermatology· Modesto, CA

Dermatology (D.O.) in Modesto, California, trained at Touro Un Col of Osteopathic Medicine, Henderson (class of 2010). 345 Medicare patients in 2024, $109,374 paid; nearly all of their 172 Part D prescriptions were generic (99%). Abbvie Inc. was the largest of 11 companies reporting payments in 2025, $1,264 in all, mostly food and beverage.

Overview

NPI	1124333455
Status	Active
Entity type	Individual
Credential	D.O.
Sole proprietor	No
NPI issued	Aug 11, 2010
Last updated in NPPES	Aug 8, 2024
Certified by provider	Aug 8, 2024

Specialties and licenses

Taxonomy	Code	License	State
Dermatology Primary	207N00000X	12765	CA
Internal Medicine	207R00000X	20A12765	CA
Internal Medicine	207R00000X	5101018747	MI
Internal Medicine	207R00000X	DO184048	OR
Hospitalist	208M00000X	20A12765	CA

About license numbers in NPPES

Exclusion screening

List	Result	Details
HHS-OIG LEIE · Oct 9, 2026	No match	Checked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026	No match	—
New York OMIG · Nov 10, 2026	No match	—
Ohio Medicaid · Nov 10, 2026	No match	—
Pennsylvania Medicheck · Nov 10, 2026	No match	—
Washington HCA · Nov 10, 2026	No match	—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)	Enrolled Practitioner - Dermatology (CA); Practitioner - Micrographic Dermatologic Surgery (Mds) (NJ)
Accepts assignment	Yes (participating)

Medicare services in 2024

Medicare patients	345
Services billed	1,620 across 57 procedure codes
Paid by Medicare	$109,374

Part D prescriptions in 2024

Prescriptions (claims)	172 · 184 30-day fills
Patients	107
Total drug cost	$5,457
Generic share	99% of claims

Medicare sources and data years

Education and affiliations

Medical school	Touro Un Col of Osteopathic Medicine, Henderson
Graduation year	2010
Medicare specialty	Micrographic Dermatologic Surgery (Mds)
Secondary specialties	Dermatology
Telehealth	Offers telehealth