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MICHELE PARK
NPI 1063215127
Physician Assistant - Medical in Corona, CA

Active since March 31, 2025PECOS EnrolledAccepts Medicare Assignment
802 MAGNOLIA AVE STE 205, CORONA, CA 92879(951) 281-2730 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 8, 2025, Mar 31, 2025 (2 updates tracked since 2025).

About Michele Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELE PARK (NPI 1063215127) is an individual medical provider in Corona, California and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1063215127
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMICHELE PARK
Location Address802 MAGNOLIA AVE STE 205Corona, CA 92879-3144
Mailing Address874 American Pacific DrHenderson, NV 89014-8800
Phone(951) 281-2730
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 31, 2025
Last NPPES UpdateSeptember 8, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2025
✔ NPI 1063215127 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
802 MAGNOLIA AVE STE 205, Corona, CA 92879
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michele Park is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5991223885
PECOS Enrollment IDI20250514002951
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RICK KIEU NGUYEN NP
Nurse Practitioner (Primary Care)
802 MAGNOLIA AVE STE 205
CORONA, CA 92879
Riverside County (951) 281-2730
ARRAE HEALTH
Internal Medicine
802 MAGNOLIA AVE STE 205
CORONA, CA 92879
Riverside County (951) 281-2730
MR. RYAN BLACK PA-C
Physician Assistant (Medical)
802 MAGNOLIA AVE STE 205
CORONA, CA 92879
Riverside County (951) 281-2730
GARVIN SIDHARAJ PATEL M.D.
Internal Medicine
802 MAGNOLIA AVE STE 205
CORONA, CA 92879
Riverside County (951) 281-2730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michele Park's NPI number?

The NPI number for Michele Park is 1063215127. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Where is Michele Park located?

Michele Park practices at 802 Magnolia Ave Ste 205, Corona, CA 92879. The listed phone number is (951) 281-2730.

What is Michele Park's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Michele Park enrolled in Medicare?

Yes. Michele Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Michele Park was last updated on September 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.