JUN SUNG PARK
NPI 1497647085
Nurse Anesthetist, Certified Registered in Los Angeles, CA
About Jun Sung Park NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUN SUNG PARK (NPI 1497647085) is an individual nurse anesthetist, certified registered in Los Angeles, California, licensed in California (95040494) and active in the NPI registry since July 2025. He is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
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
Jun Sung 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.
Medicare Billing Reassignment
Medicare enrollment records show Jun Sung Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90034
- Reassigned Medicare billing, California enrollment
- 13,921 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90034 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.
LOS ANGELES, CA 90034
LOS ANGELES, CA 90034
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 Jun Sung Park's NPI number?
The NPI number for Jun Sung Park is 1497647085. It was assigned to this individual provider in the NPPES registry on July 17, 2025.
Where is Jun Sung Park located?
Jun Sung Park practices at 6041 Cadillac Ave, Los Angeles, CA 90034. The listed phone number is (833) 574-2273.
What is Jun Sung Park's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Jun Sung Park enrolled in Medicare?
Yes. Jun Sung 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 Jun Sung Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jun Sung Park reassigns Medicare benefits to Southern California Permanente Medical Group (Los Angeles, CA). 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 Jun Sung 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 Jun Sung Park was last updated on August 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jun Sung Park · NPI 1497647085
Nurse Anesthetist, Certified Registered physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since July 17, 2025.
## Identity
- **NPI:** 1497647085 (Entity type: Individual)
- **Enumerated:** July 17, 2025
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 95040494 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6041 CADILLAC AVE, Los Angeles, CA 90034-1702
- **Phone:** (833) 574-2273
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1043242563, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 5, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1497647085) · Data from the CMS NPPES public registry.