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MR. RYAN PARK NP
NPI 1760738728
Nurse Practitioner in Saint Augustine, FL

Active since July 27, 2012PECOS EnrolledAccepts Medicare Assignment
559 W TWINCOURT TRL STE 607-608, SAINT AUGUSTINE, FL 32095(904) 230-3006(877) 638-8891 Get Directions Write a Review

NPPES record last updated: March 6, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 6, 2024, Apr 26, 2018 (2 updates tracked since 2018).

About Mr. Ryan Park Np NPPES

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

MR. RYAN PARK NP (NPI 1760738728) is an individual nurse practitioner in Saint Augustine, Florida, licensed in Florida (APRN11030031) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1760738728
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. RYAN PARKCredential: NP
Location Address559 W TWINCOURT TRL STE 607-608Saint Augustine, FL 32095-8805
Mailing Address559 W Twincourt Trl Ste 607-608Saint Augustine, FL 32095-8805 · (904) 230-3006 · Fax (877) 638-8891
Phone(904) 230-3006
Fax(877) 638-8891
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 27, 2012
Last NPPES UpdateMarch 6, 20242 updates tracked since enumeration
NPPES CertifiedMarch 6, 2024
✔ NPI 1760738728 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 FL · APRN11030031
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 ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License NP-1200A (ID)
559 W TWINCOURT TRL STE 607-608, Saint Augustine, FL 32095
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Secondary Practice Locations 3

Location 1360 E Montvue Dr. Ste 100Meridian, ID 83642 · Phone (208) 855-2900 · Fax (208) 898-9877
Location 257 Town Ct Ste 123Palm Coast, FL 32164-2425 · Phone (904) 230-3006 · Fax (877) 638-8891
Location 31021 Cesery BlvdJacksonville, FL 32211-5609 · Phone (904) 743-2466

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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

Mr. Ryan Park Np 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.

PECOS PAC ID9436300654
PECOS Enrollment IDI20240511000036
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.

Medicare Billing Reassignments

6

Medicare enrollment records show Ryan Park reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Estate Ventures, LLC
Same address
Pain Medicine
559 W TWINCOURT TRL, #607
St Augustine, FL 32095
  • Reassigned Medicare billing, Florida enrollment
  • 2 clinicians in this Medicare group
NPI 1033505706 (904) 230-3006
Solantic Of Jacksonville, LLC
8.7 mi
Urgent Care
151 PINE LAKE DRIVE, SUITE B
Ponte Vedra, FL 32081
  • Reassigned Medicare billing, Florida enrollment
  • 189 clinicians in this Medicare group
NPI 1407893100 (904) 543-3677
Carespot Of Orlando Hsi Urgent Care LLC
101 mi
Urgent Care
311 SOUTH AVALON PARK BLVD
Orlando, FL 32828
  • Reassigned Medicare billing, Florida enrollment
  • 133 clinicians in this Medicare group
NPI 1306367503 (407) 295-7557
Hma/Solantic Joint Venture, LLC
173 mi
Urgent Care
1820 58TH AVE., UNIT 110
Vero Beach, FL 32966
  • Reassigned Medicare billing, Florida enrollment
  • 160 clinicians in this Medicare group
NPI 1689812109 (772) 257-3200
West Boynton Urgent Care, LLC
251 mi
Urgent Care
8756 BOYNTON BEACH BLVD, SUITE 150
Boynton Beach, FL 33472
  • Reassigned Medicare billing, Florida enrollment
  • 83 clinicians in this Medicare group
NPI 1003172628 (561) 740-2273
Solantic/South Florida, LLC
268 mi
Urgent Care
1205 N UNIVERSITY DR
Coral Springs, FL 33071
  • Reassigned Medicare billing, Florida enrollment
  • 167 clinicians in this Medicare group
NPI 1851344378 (954) 780-8134

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
80 services61 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
31 services31 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
21 services21 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
19 services19 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
15 services15 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32095 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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 Ryan Park's NPI number?

The NPI number for Ryan Park is 1760738728. It was assigned to this individual provider in the NPPES registry on July 27, 2012.

Where is Ryan Park located?

Ryan Park practices at 559 W Twincourt Trl Ste 607-608, Saint Augustine, FL 32095. The listed phone number is (904) 230-3006.

What is Ryan Park's specialty?

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

Is Ryan Park enrolled in Medicare?

Yes. Ryan 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 organizations bill Medicare for Ryan Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ryan Park reassigns Medicare benefits to 6 organizations: Estate Ventures, LLC (St Augustine, FL), Solantic Of Jacksonville, LLC (Ponte Vedra, FL), Carespot Of Orlando Hsi Urgent Care LLC (Orlando, FL), Hma/Solantic Joint Venture, LLC (Vero Beach, FL), West Boynton Urgent Care, LLC (Boynton Beach, FL) and 1 more organization, listed in the Medicare section above. 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 Ryan 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 Ryan Park was last updated on March 6, 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.