SE J Park, NP-C, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95023379 Issued in CA

Practice address

1000 Fivepoint
Irvine, CA 92618-2377

Phone

(800) 826-4673

NPI assigned

Feb 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Andrew Park Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA, CA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Emory University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of Hope Medical FoundationGroup PAC ID 3779751656, 964 clinicians

Uci Department of UrologyGroup PAC ID 6901799238, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• City of Hope Helford Clinical Research Hospital Hospital, Duarte, CA, CCN 050146
• Uci Health-Orange Hospital, Orange, CA, CCN 050348

Merit-based Incentive Payment System (MIPS)

Final score

92.39 of 100Reported as group

Quality

84.79

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: direct@cityofhope.direct-ci.com
• Direct secure messaging: apark133557@directwellstar.org
• Direct secure messaging: spark272743@cityofhope.direct-ci.com

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.

• City of Hope Medical Foundation

  • Hematology & Oncology Physician
  • Duarte, CA
  • NPI 1871886366
  Medicare reassignment Care Compare group NPD
• Uci Department of Urology

  • Urology Physician
  • Orange, CA
  • NPI 1255398533
  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Urology Physician
  • Marietta, GA
  • NPI 1467883512
  NPD

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

• City of Hope National Medical Center

  • General Acute Care Hospital
  • Duarte, CA
  • NPI 1750358297
  Care Compare affiliation
• University of California Irvine

  • Urgent Care Clinic/Center
  • Irvine, CA
  • NPI 1518739309

  Hospital

  Care Compare affiliation
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  Care Compare affiliation

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1871031518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FIVEPOINT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182377",
            "telephone_number": "800-826-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Duarte Rd",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "910103012",
            "country_code": "US",
            "telephone_number": "800-826-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Whitcher St NE Ste 250",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601169",
            "country_code": "US",
            "telephone_number": "770-428-4475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "SE",
        "middle_name": "J",
        "credential": "NP-C, DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-02",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN243386",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95023379",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95023379",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN243386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Fivepoint",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926182377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREW",
            "last_name": "PARK",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madison Seong-He Park, DACCHM, LAC
• Mi Ran Park, L.AC.
• Mikyung Park
• Moonjoo Park
• Sarah Park
• So Y Park, L.AC.
• Sunmin Park
• Susan Lee Park, NP, L AC
• Susie Park, OTR/L
• Tony J Park, PHARM.D., J.D.

• Nurse Practitioner in Irvine, CA
• Providers in Irvine, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.