JOHN PARK
NPI 1417503830
Family Medicine in Santa Clara, CA
About John Park NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN PARK (NPI 1417503830) is an individual family medicine provider in Santa Clara, California, licensed in Pennsylvania (OT019677) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2019).
NPPES Registry Identity
Specialties & Licenses
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
John 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 95051 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.
SANTA CLARA, CA 95051
SANTA CLARA, CA 95051
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 John Park's NPI number?
The NPI number for John Park is 1417503830. It was assigned to this individual provider in the NPPES registry on August 12, 2019.
Where is John Park located?
John Park practices at 710 Lawrence Expy, Santa Clara, CA 95051. The listed phone number is (781) 879-9774.
What is John Park's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is John Park enrolled in Medicare?
Yes. John 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.
When was this NPI record last updated?
The NPPES record for John Park was last updated on January 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# John Park · NPI 1417503830
Family Medicine physician in Santa Clara, California. Individual provider, active in the CMS NPPES registry since August 12, 2019.
## Identity
- **NPI:** 1417503830 (Entity type: Individual)
- **Enumerated:** August 12, 2019
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** OT019677 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 710 LAWRENCE EXPY, Santa Clara, CA 95051-5173
- **Phone:** (781) 879-9774
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Lake Erie College Of Osteopathic Medicine, Erie, class of 2019
## Record status
- **NPPES last updated:** January 11, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1417503830) · Data from the CMS NPPES public registry.