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TONY JUNGWOO PARK
NPI 1144686577
Nurse Practitioner - Psychiatric/Mental Health in Buena Park, CA

Active since January 14, 2016PECOS EnrolledAccepts Medicare Assignment
7212 ORANGETHORPE AVE STE 9A, BUENA PARK, CA 90621(714) 503-6550(714) 409-3075 Get Directions Write a Review

NPPES record last updated: November 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 4, 2024, Jun 30, 2016, Jan 14, 2016 (3 updates tracked since 2016).

About Tony Jungwoo Park NPPES

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

TONY JUNGWOO PARK (NPI 1144686577) is an individual psychiatric/mental health provider in Buena Park, California, licensed in California (2020011541) and active in the NPI registry since January 2016. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1144686577
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameTONY JUNGWOO PARK
Location Address7212 ORANGETHORPE AVE STE 9ABuena Park, CA 90621-4668
Mailing Address53 Scarlet BloomIrvine, CA 92618-8808 · (858) 740-4142
Phone(714) 503-6550
Fax(714) 409-3075
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 14, 2016
Last NPPES UpdateNovember 4, 20243 updates tracked since enumeration
NPPES CertifiedNovember 4, 2024
✔ NPI 1144686577 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 2020011541
Also ListedRegistered NurseTaxonomy 163W00000X · License 835101 (CA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95003723 (CA)
7212 ORANGETHORPE AVE STE 9A, Buena Park, CA 90621
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tony Jungwoo 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 ID3971971177
PECOS Enrollment IDI20221118002245
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.

Medicare Billing Reassignment

Medicare enrollment records show Tony Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kcs, Inc.
Same address
Federally Qualified Health Center (FQHC)
7212 ORANGETHORPE AVE STE 9A
Buena Park, CA 90621
  • Reassigned Medicare billing, California enrollment
  • 32 clinicians in this Medicare group
NPI 1861525602 (714) 503-6550

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90621 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

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

CAITLYN JEEIN PARK
Nurse Practitioner (Family)
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550
RANA CHOI NP
Nurse Practitioner (Family)
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550
MARIEGRACE MERO R.N.
Registered Nurse
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 562-8729
KCS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550
NICHOLE AMBER QUICK M.D.
Preventive Medicine (Public Health & General Preventive Medicine)
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 527-6551
EUNA LIM PARK
Social Worker (Clinical)
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550
KCS, INC.
Community/Behavioral Health
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550
KCS, INC.
Community/Behavioral Health
7212 ORANGETHORPE AVE STE 9A
BUENA PARK, CA 90621
Orange County (714) 503-6550

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 Tony Park's NPI number?

The NPI number for Tony Park is 1144686577. It was assigned to this individual provider in the NPPES registry on January 14, 2016.

Where is Tony Park located?

Tony Park practices at 7212 Orangethorpe Ave Ste 9A, Buena Park, CA 90621. The listed phone number is (714) 503-6550.

What is Tony Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tony Park enrolled in Medicare?

Yes. Tony 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.

Which organization bills Medicare for Tony Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tony Park reassigns Medicare benefits to Kcs, Inc. (Buena Park, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tony Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tony Park was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.