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DR. SAMUEL A PARK M.D
NPI 1902014566
Specialist in Beverly Hills, CA

Active since May 18, 2007Opted out of Medicare · through Apr 9, 2028
9301 WILSHIRE BLVD, SUITE 601, BEVERLY HILLS, CA 90210(310) 777-0490(310) 246-9422 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Samuel A Park M.d NPPES

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

DR. SAMUEL A PARK M.D (NPI 1902014566) is an individual specialist in Beverly Hills, California, licensed in California (G67123) and active in the NPI registry since May 2007. He has opted out of Medicare through April 9, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1902014566
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. SAMUEL A PARKCredential: M.D
Location Address9301 WILSHIRE BLVD, SUITE 601Beverly Hills, CA 90210-5424
Mailing Address9301 Wilshire Blvd, Suite 601Beverly Hills, CALIFORNIA 90210 · (310) 777-0490 · Fax (310) 246-9422
Phone(310) 777-0490
Fax(310) 246-9422
Sole ProprietorNo
Enumeration DateMay 18, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1902014566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · G67123
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
9301 WILSHIRE BLVD, Beverly Hills, CA 90210
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Samuel A Park M.d has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 9, 2014 through April 9, 2028.

Opt-Out Effective DateApril 9, 2014
Opt-Out In Effect ThroughApril 9, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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.

MICHAEL D. BOROOKHIM, M.D., INC
Internal Medicine
9301 WILSHIRE BLVD, SUITE 602
BEVERLY HILLS, CA 90210
Los Angeles County (310) 288-0881
DANNY BENMOSHE, M.D., INC.
Psychiatry & Neurology (Neurology)
9301 WILSHIRE BLVD, STE 512
BEVERLY HILLS, CA 90210
Los Angeles County (315) 726-3876
HOMAYOUN SHARIM M.D.
Internal Medicine
9301 WILSHIRE BLVD, SUITE 512
BEVERLY HILLS, CA 90210
Los Angeles County (310) 657-8000
BEVERLY HILLS PLASTIC SURGERY GROUP INC
Plastic Surgery
9301 WILSHIRE BLVD, SUITE 302
BEVERLY HILLS, CA 90210
Los Angeles County (310) 275-6600
DR. NATAN RYAN SHAOULIAN M.D.
Psychiatry & Neurology (Neurology)
9301 WILSHIRE BLVD, SUITE 600
BEVERLY HILLS, CA 90210
Los Angeles County (310) 278-2525
THASANA NIVATPUMIN M.D.
Internal Medicine (Cardiovascular Disease)
9301 WILSHIRE BLVD, SUITE 602
BEVERLY HILLS, CA 90210
Los Angeles County (310) 271-7012
ADAM TANNER-HILL PT
Physical Therapist
9301 WILSHIRE BLVD, SUITE 502
BEVERLY HILLS, CA 90210
Los Angeles County (310) 275-2800
REXFORD OPERATING ROOMS INC.
Clinic/Center (Ambulatory Surgical)
9301 WILSHIRE BLVD, SUITE # 125
BEVERLY HILLS, CA 90210
Los Angeles County (310) 777-0033

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 Samuel Park's NPI number?

The NPI number for Samuel Park is 1902014566. It was assigned to this individual provider in the NPPES registry on May 18, 2007.

Where is Samuel Park located?

Samuel Park practices at 9301 Wilshire Blvd Suite 601, Beverly Hills, CA 90210. The listed phone number is (310) 777-0490.

What is Samuel Park's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Samuel Park enrolled in Medicare?

No. Samuel Park has opted out of Medicare through April 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Samuel Park was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.