PETER S PARK FNP
NPI 1154937241
Nurse Practitioner in Grandview, WA

Q: 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.

Q: What is Peter Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: 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.

Active since September 23, 2020PECOS EnrolledAccepts Medicare Assignment

88.39/100

CMS Quality Rating

1003 WALLACE WAY, GRANDVIEW, WA 98930(509) 786-2222 Get Directions Write a Review

NPPES record last updated: June 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2021, Jan 24, 2021, Nov 28, 2020 and 1 more (4 updates tracked since 2020).

On this page

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

NPI1154937241

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NamePETER S PARKCredential: FNP

Location Address1003 WALLACE WAYGrandview, WA 98930-8805

Mailing Address1003 Wallace WayGrandview, WA 98930-8805 · (509) 203-1080

Phone(509) 786-2222

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateSeptember 23, 2020

Last NPPES UpdateJune 2, 20214 updates tracked since enumeration

NPPES CertifiedJune 2, 2021

✔ NPI 1154937241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WA · AP61125867

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1003 WALLACE WAY, Grandview, WA 98930

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

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

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.

PECOS PAC ID5890100440

PECOS Enrollment IDI20210212002122

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.

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, WA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number501312

Location723 Memorial StreetProsser, WA 99350 · Benton County

Emergency services

Physician 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.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

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.

88.39/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

89.25

Promoting Interoperability

Improvement Activities

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.

DENNIS MOORE M.D.

Pediatrics