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MIN PARK NP
NPI 1619826476
Nurse Practitioner - Family in Fairfax, VA

Active since January 26, 2026PECOS Enrolled
11240 WAPLES MILL RD STE 300, FAIRFAX, VA 22030(571) 407-5042 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Min Park Np NPPES

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

MIN PARK NP (NPI 1619826476) is an individual family provider in Fairfax, Virginia, licensed in Virginia (0024195870) and active in the NPI registry since January 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1619826476
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMIN PARKCredential: NP
Location Address11240 WAPLES MILL RD STE 300Fairfax, VA 22030-6078
Mailing Address11240 Waples Mill Rd Ste 300Fairfax, VA 22030-6078 · (571) 407-5042
Phone(571) 407-5042
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJanuary 26, 2026
NPPES CertifiedJanuary 26, 2026
✔ NPI 1619826476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in VA · 0024195870
11240 WAPLES MILL RD STE 300, Fairfax, VA 22030
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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)

Min Park Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547742876
PECOS Enrollment IDI20260305000772
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 22030 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA KAPNER
Behavior Technician
11240 WAPLES MILL RD STE 300
FAIRFAX, VA 22030
Fairfax City (703) 237-2219
NOVA PAIN MANAGEMENT CENTER INC
Internal Medicine
11240 WAPLES MILL RD STE 300
FAIRFAX, VA 22030
Fairfax City (703) 752-4623

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 Min Park's NPI number?

The NPI number for Min Park is 1619826476. It was assigned to this individual provider in the NPPES registry on January 26, 2026.

Where is Min Park located?

Min Park practices at 11240 Waples Mill Rd Ste 300, Fairfax, VA 22030. The listed phone number is (571) 407-5042.

What is Min Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Min Park enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Min Park was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.