Individual provider Active NPI

Minna Park, NP

  • Family Nurse Practitioner
  • Flushing, NY
National Provider Identifier
1962831537
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337877 Issued in NY
Practice address
16410 Northern Blvd
Suite 206
Flushing, NY 11358-2677
Phone
(718) 321-2940
NPI assigned
Nov 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 337877 NY Primary

Addresses

Primary practice location

16410 Northern Blvd
Suite 206
Flushing, NY 11358-2677

Mailing address

216 W 100TH St
Apt 920
New York, NY 10025-5018
Phone (347) 768-1551

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160726001567 NY Practitioner - Nurse Practitioner 1850684051 Reassigns benefits to 2 organizations
Practice locations: Flushing, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

2510 30TH Ave
Astoria, NY 11102-2448
Phone (718) 932-1000

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2022 Accepting new patients
The Rogosin Institute, Inc CurrentSince Dec 3, 2017 Accepting new patients
The Rogosin Institute Inc CurrentSince Dec 3, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2022 Accepting new patients

Locations

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119

505 E 70th St
Fl 2
New York, NY 10021
Phone (212) 746-1578

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

6620 Queens Blvd
Woodside, NY 11377
Phone (718) 457-3000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1962831537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 W 100TH ST",
            "address_2": "APT 920",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255018",
            "telephone_number": "347-768-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 NORTHERN BLVD",
            "address_2": "SUITE 206",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582677",
            "telephone_number": "718-321-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MINNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.