Individual provider Active NPI

Selin Park, FNP

  • Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1710877782
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15363200 Issued in NJ
Practice address
200 Grand Ave Ste 201
Englewood, NJ 07631-4363
Phone
(201) 944-3800
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 26NJ15363200 NJ Primary

Addresses

Primary practice location

200 Grand Ave Ste 201
Englewood, NJ 07631-4363

Mailing address

200 Grand Ave Ste 201
Englewood, NJ 07631-4363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20250930002830 NJ Practitioner - Nurse Practitioner 1153827043 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joo Medical CenterGroup PAC ID 9234415688, 3 clinicians
DRX Paramus, LLCGroup PAC ID 2466589585, 63 clinicians

Practice addresses (Care Compare)

388 Broad Ave
Leonia, NJ 07605-1715
Phone (201) 292-1567

4200 Bergenline Ave
Union City, NJ 07087-4924
Phone (551) 257-1948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Radiology Group of New Jersey, LLC Single Specialty CurrentSince Sep 1, 2025 Accepting new patients
Joo Medical Center Single Specialty CurrentSince Feb 9, 2026 Accepting new patients
DRX Paramus, LLC Single Specialty CurrentSince Sep 1, 2025 Accepting new patients
Hudson MD Group Single Specialty CurrentSince Jul 24, 2025 Accepting new patients
David W. Lee MD PA Single Specialty PastSince Feb 6, 2007 Accepting new patients

Locations

2001 College Dr
Ste 11
Clementon, NJ 08021
Phone (856) 566-3333

200 Grand Ave
Ste 201
Englewood, NJ 07631
Phone (201) 944-3800

1625 Anderson Ave
Ste 204
Fort Lee, NJ 07024
Phone (201) 224-0011

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

388 Broad Ave
Leonia, NJ 07605
Phone (201) 292-1565

243 Chestnut St
Ste 3
Newark, NJ 07105
Phone (973) 274-9880

175 High St
Newton, NJ 07860
Phone (973) 383-2121

67 E Ridgewood Ave
Unit C
Paramus, NJ 07652
Phone (201) 262-2010

9 Hospital Dr
Ste A22
Toms River, NJ 08755
Phone (973) 429-1300

4200 Bergenline Ave
Union City, NJ 07087
Phone (551) 251-1948

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1710877782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE STE 201",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314363",
            "telephone_number": "201-944-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SELIN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15363200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.