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MINA PARK AGNP-C
NPI 1417312406
Nurse Practitioner in Los Angeles, CA

Active since December 18, 2015PECOS Enrolled
8650 BELFORD AVE APT 225, LOS ANGELES, CA 90045(818) 987-5088 Get Directions Write a Review

NPPES record last updated: December 18, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mina Park Agnp-c NPPES

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

MINA PARK AGNP-C (NPI 1417312406) is an individual nurse practitioner in Los Angeles, California, licensed in California (95002208) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417312406
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMINA PARKCredential: AGNP-C
Location Address8650 BELFORD AVE APT 225Los Angeles, CA 90045-4553
Mailing Address8650 Belford Ave Apt 225Los Angeles, CA 90045-4553 · (818) 987-5088
Phone(818) 987-5088
Sole ProprietorNo
Enumeration DateDecember 18, 2015
✔ NPI 1417312406 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 CA · 95002208
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 ListedRegistered Nurse · GerontologyTaxonomy 163WG0600X · License 95002208 (CA)
8650 BELFORD AVE APT 225, Los Angeles, CA 90045
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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 (PECOS)

Mina Park Agnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90045 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.

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 Mina Park's NPI number?

The NPI number for Mina Park is 1417312406. It was assigned to this individual provider in the NPPES registry on December 18, 2015.

Where is Mina Park located?

Mina Park practices at 8650 Belford Ave Apt 225, Los Angeles, CA 90045. The listed phone number is (818) 987-5088.

What is Mina Park's specialty?

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

Is Mina Park enrolled in Medicare?

Yes. Mina Park is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mina Park was last updated on December 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.