Individual provider Active NPI

Seu NA Park, MSN, FNP-BC, RN

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1063816882
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95001327 Issued in CA
Practice address
10833 Le Conte Ave
Los Angeles, CA 90095-2200
Phone
(310) 825-6078
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 794846 CA
Family Nurse Practitioner 363LF0000X NP95001327 CA
Nurse Practitioner 363L00000X NP95001327 CA Primary

Addresses

Primary practice location

10833 Le Conte Ave
Los Angeles, CA 90095-2200

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 825-6078

Other practice location 1

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307000191 CA Practitioner - Nurse Practitioner 5395041065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCLA Associated General SurgeonsGroup PAC ID 6002728144, 46 clinicians

Practice addresses (Care Compare)

1260 15TH St
Suite 1200
Santa Monica, CA 90404-1147
Phone (310) 451-8751

Merit-based Incentive Payment System (MIPS)

Final score
92.77 of 100Reported as group
Quality
69.77
Promoting interoperability
100
Improvement activities
40
Cost
82.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
794846CAMDRegistered Nurse
NP95001327CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Associated General Surgeons CurrentSince May 1, 2018 Accepting new patients
UCLA Medical Group Past Accepting new patients
UCLA Associated General Surgeons Past Accepting new patients

Locations

File 54206
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1260 15th St
Ste 1200
Santa Monica, CA 90404
Phone (310) 451-8751

3500 Lomita Blvd
Ste M100
Torrance, CA 90505
Phone (310) 325-7404

6344 Topanga Canyon Blvd
Ste 20
Woodland Hills, CA 91367

6344 Topanga Canyon Blvd
Ste 204
Woodland Hills, CA 91367

Interoperability endpoints

  • Direct secure messaging: spark614010@direct.uclahealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1063816882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-825-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10833 LE CONTE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900952200",
            "telephone_number": "310-825-6078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SEU NA",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "794846",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001327",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95001327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.