Anna Park, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

309359 Issued in NY

Practice address

4004 Bowne St Apt 1I
Flushing, NY 11354-6129

Phone

(718) 539-3359

NPI assigned

Aug 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Queens - Ny Medical, P.C.

  • Internal Medicine Physician
  • Flushing, NY
  • NPI 1316077068
  Medicare reassignment NPD

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1083260095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2276 41ST ST APT 3A",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051723",
            "telephone_number": "831-420-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 BOWNE ST APT 1I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546129",
            "telephone_number": "718-539-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Chiropractic Healthcare P.C.
• Park Avenue Nephrology & Medicine, PC
• Park Chiropractic Pain Care, P.C.
• Allison Sunghye Park, DMD
• Angela Park, LCSW
• Cheonjun Park
• Chong H Park, MD
• Chongmin Park, D.D.S.
• Dong H Park, L.AC
• Esther J Park, M.D.

• Adult Health Nurse Practitioner in Flushing, NY
• Providers in Flushing, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.