PETER S PARK FNP
NPI 1154937241
Nurse Practitioner in Grandview, WA
About Peter S Park Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PETER S PARK FNP (NPI 1154937241) is an individual nurse practitioner in Grandview, Washington, licensed in Washington (AP61125867) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS, is affiliated with Prosser Memorial Hospital, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
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
Peter S Park Fnp 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.
Medicare Billing Reassignment
Medicare enrollment records show Peter Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grandview, WA 98930
- Reassigned Medicare billing, Washington enrollment
- Also billed through NPI 1306897681 (Washington)
- 232 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Prosser Memorial Hospital
Critical Access Hospitals · Prosser, WAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98930 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRANDVIEW, WA 98930
GRANDVIEW, WA 98930
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 Peter Park's NPI number?
The NPI number for Peter Park is 1154937241. It was assigned to this individual provider in the NPPES registry on September 23, 2020.
Where is Peter Park located?
Peter Park practices at 1003 Wallace Way, Grandview, WA 98930. The listed phone number is (509) 786-2222.
What is Peter Park's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Peter Park enrolled in Medicare?
Yes. Peter 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 Peter Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Peter Park reassigns Medicare benefits to Prosser Public Hospital District Of Benton County (Grandview, WA). 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 Peter Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Peter Park accept?
Health plans from Ambetter Health, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Peter Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Peter Park affiliated with any hospitals?
According to CMS data, Peter Park is affiliated with Prosser Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Peter Park was last updated on June 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Peter S Park, FNP · NPI 1154937241
Nurse Practitioner physician in Grandview, Washington. Individual provider, active in the CMS NPPES registry since September 23, 2020.
## Identity
- **NPI:** 1154937241 (Entity type: Individual)
- **Enumerated:** September 23, 2020
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** AP61125867 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 1003 WALLACE WAY, Grandview, WA 98930-8805
- **Phone:** (509) 786-2222
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Prosser Public Hospital District Of Benton County (NPI 1376026237, Grandview, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** June 2, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1154937241) · Data from the CMS NPPES public registry.