Grace Eunjin Park, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

27457 Issued in NE

Practice address

5005 N Piedras St
El Paso, TX 79930-5097

Phone

(915) 742-1900

Fax

(915) 742-9488

NPI assigned

Feb 16, 2012

Sex

Female

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 NM

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

Urology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Cruces Physician Practices, LLCGroup PAC ID 7618974858, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: grace.park.1@19849.direct.athenahealth.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.

• Las Cruces Physician Practices, LLC

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1093947491
  Medicare reassignment Care Compare group
• Las Cruces Physician Practices, LLC

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1346586195
  NPD

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

• PHC-Las Cruces Inc

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1700821808
  Care Compare affiliation

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1982977278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799305097",
            "telephone_number": "915-742-1900",
            "fax_number": "915-742-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799305097",
            "telephone_number": "915-742-1900",
            "fax_number": "915-742-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "GRACE",
        "middle_name": "EUNJIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "27457",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "27457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graciela Pargas
• Alexa R Parilla
• Tiffany Paris Ferrer
• Satya Priya Paritala
• Chris Park, RRT
• Ki Chae Park, L.AC. DAOM.
• Mina Grace Park
• Patricia B. Park, LCSW
• Richard L. Park, PH.D., LCSW
• Robert M Parke, FNP-BC

• Urology Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.