ELLEN SAE EUN PARK N.P
NPI 1922559442
Nurse Practitioner - Primary Care in Buena Park, CA
About Ellen Sae Eun Park N.p NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELLEN SAE EUN PARK N.P (NPI 1922559442) is an individual primary care provider in Buena Park, California, licensed in California (95005023) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ellen Sae Eun Park N.p is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ellen Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tustin, CA 92780
- Reassigned Medicare billing, California enrollment
- 2,052 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 90620 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 3
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 Ellen Park's NPI number?
The NPI number for Ellen Park is 1922559442. It was assigned to this individual provider in the NPPES registry on October 19, 2016. The provider is also known as Sae Eun Park N.P.
Where is Ellen Park located?
Ellen Park practices at 6900 Lincoln Ave, Buena Park, CA 90620. The listed phone number is (714) 522-4009.
What is Ellen Park's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Ellen Park enrolled in Medicare?
Yes. Ellen Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ellen Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ellen Park reassigns Medicare benefits to Healthcare Partners Affiliates Medical Group (Tustin, 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 Ellen 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 Ellen Park was last updated on April 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Ellen Sae Eun Park, N.P · NPI 1922559442
Primary Care physician in Buena Park, California. Individual provider, active in the CMS NPPES registry since October 19, 2016.
## Identity
- **NPI:** 1922559442 (Entity type: Individual)
- **Enumerated:** October 19, 2016
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 95005023 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6900 LINCOLN AVE, Buena Park, CA 90620-4148
- **Phone:** (714) 522-4009
## 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:** Healthcare Partners Affiliates Medical Group (NPI 1891981502, Tustin, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1922559442) · Data from the CMS NPPES public registry.