Jonathan Park, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A165509 Issued in CA

Practice address

8876 Mission Blvd
Jurupa Valley, CA 92509-2811

Phone

(951) 360-8795

NPI assigned

Apr 28, 2018

Last updated

Jul 8, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Oakland Univ, William Beaumont School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292
• Southern Coos Hospital & Health Center Hospital, Bandon, OR, CCN 381304
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpark306923@direct.llu.edu

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.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment Care Compare group NPD
• Emergency Physicians Urgent Care Inc.

  dba Accelerated Urgent Care

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1689963845
  Medicare reassignment NPD
• JBP Medical Group

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1295442010
  NPD Authorized official
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Lake Elsinore, CA
  • NPI 1396859179
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD
• Emergency Physicians Urgent Care Inc.

  dba Accelerated Urgent Care

  • Urgent Care Clinic/Center
  • Bakersfield, CA
  • NPI 1629442728
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Riverside

  • General Acute Care Hospital
  • Moreno Valley, CA
  • NPI 1821159195
  Care Compare affiliation
• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Southern Coos Health District

  • Critical Access Hospital
  • Bandon, OR
  • NPI 1588684484
  Care Compare affiliation

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

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1205324969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-360-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8876 MISSION BLVD",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925092811",
            "telephone_number": "951-360-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-28",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A165509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Melissa Padilla
• Chelsy America Palafox
• Jose L Pallares, PPS
• Jasmin Isabel Panfilo
• Courtney Pappas
• Chandra Partlow
• Daisy Pearson
• Job Perez Jr
• Jennifer Elaine Perez, RN
• Omar Perez

• Family Medicine Physician in Jurupa Valley, CA
• Providers in Jurupa Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.