SHELLEY J PARK N.P.
NPI 1386683480
Nurse Practitioner in Redlands, CA
About Shelley J Park N.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHELLEY J PARK N.P. (NPI 1386683480) is an individual nurse practitioner in Redlands, California, licensed in California (14554) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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
Shelley J Park N.p. 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 Reassignments
2Medicare enrollment records show Shelley Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Redlands, CA 92373
- Reassigned Medicare billing, California enrollment
- 635 clinicians in this Medicare group
Tustin, CA 92780
- Reassigned Medicare billing, California enrollment
- 2,052 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.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92373 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Shelley Park's NPI number?
The NPI number for Shelley Park is 1386683480. It was assigned to this individual provider in the NPPES registry on June 5, 2006. The provider is also known as Shelley J Anderson N.P..
Where is Shelley Park located?
Shelley Park practices at 2 W Fern Ave, Redlands, CA 92373. The listed phone number is (909) 793-3311.
What is Shelley Park's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Shelley Park enrolled in Medicare?
Yes. Shelley 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 organizations bill Medicare for Shelley Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shelley Park reassigns Medicare benefits to 2 organizations: Beaver Medical Group P C (Redlands, CA) and Healthcare Partners Affiliates Medical Group (Tustin, CA). Each 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 Shelley 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 Shelley Park was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Shelley J Park, N.P. · NPI 1386683480
Nurse Practitioner physician in Redlands, California. Individual provider, active in the CMS NPPES registry since June 5, 2006.
## Identity
- **NPI:** 1386683480 (Entity type: Individual)
- **Enumerated:** June 5, 2006
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 14554 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2 W FERN AVE, Redlands, CA 92373-5916
- **Phone:** (909) 793-3311 · **Fax:** (909) 796-4158
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Beaver Medical Group P C (NPI 1649503319, Redlands, CA); Healthcare Partners Affiliates Medical Group (NPI 1891981502, Tustin, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** January 5, 2026
- **Other identifiers:** Medicaid ZZZ08162Z (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1386683480) · Data from the CMS NPPES public registry.