MIN PARK NP
NPI 1619826476
Nurse Practitioner - Family in Fairfax, VA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Min Park Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Min Park reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fairfax, VA 22030
- Reassigned Medicare billing, District of Columbia enrollment
- 4 clinicians in this Medicare group
Fairfax, VA 22030
- Reassigned Medicare billing, District of Columbia enrollment
- 3 clinicians in this Medicare group
Annandale, VA 22003
- Reassigned Medicare billing, District of Columbia enrollment
- 8 clinicians in this Medicare group
Annandale, VA 22003
- Reassigned Medicare billing, District of Columbia enrollment
- 9 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 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.
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.
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.
Which organizations bill Medicare for Min Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Min Park reassigns Medicare benefits to 4 organizations: Nova Pain Management Center Inc (Fairfax, VA), Sun Medical LLC (Fairfax, VA), International Natura Clinic Center LLC (Annandale, VA) and Sun Medical Center, LLC (Annandale, VA). 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 Min 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 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 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.
# Min Park, NP · NPI 1619826476
Family physician in Fairfax, Virginia. Individual provider, active in the CMS NPPES registry since January 26, 2026.
## Identity
- **NPI:** 1619826476 (Entity type: Individual)
- **Enumerated:** January 26, 2026
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0024195870 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 11240 WAPLES MILL RD STE 300, Fairfax, VA 22030-6078
- **Phone:** (571) 407-5042
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Nova Pain Management Center Inc (NPI 1245812825, Fairfax, VA); Sun Medical LLC (NPI 1255123170, Fairfax, VA); International Natura Clinic Center LLC (NPI 1588941934, Annandale, VA); Sun Medical Center, LLC (NPI 1871970574, Annandale, VA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** January 26, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1619826476) · Data from the CMS NPPES public registry.