Tiffany Ruth Park, DO
NPI 1285476507ActiveIndividual· General Practice· San Antonio, TX
General Practice (DO) in San Antonio, Texas, licensed in CO, with an NPI issued in June 2024. Enrolled in Medicare as order and referring only - pediatric medicine.
Overview
| NPI | 1285476507 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | Jun 7, 2024 |
| Last updated in NPPES | Dec 13, 2025 |
| Certified by provider | Dec 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | DR.0076342 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Pediatric Medicine (CO) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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