PETER SANG-WOOK PARK (DPM) – Foot & Ankle Surgery Podiatrist, NPI 1104825033
Foot & Ankle Surgery Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,833 PODIATRY in CA
Provider Addresses for PETER SANG-WOOK PARK (DPM)
1501 W Commonwealth Ave
Fullerton, CA 928332727
Phone: (714) 410-3100
Type: Location
3130 W Olympic Blvd Ste 170
Los Angeles, CA 900062648
Phone: (323) 732-7551
Type: Location
1501, West Commonwealth Avenue, Fullerton, Orange County, California, 92833, United States
FULLERTON, CA 928332727
Phone: (714) 410-3100
Type: Location
1417, Stein Strauss Street, Fullerton, Orange County, California, 92833, United States
FULLERTON, CA 928332159
Phone: (714) 797-3668
Type: Mailing
PO BOX 35380
LAS VEGAS, NV 891335380
Phone: (702) 579-3203
Type: Mailing
8311 FLORENCE AVE
DOWNEY, CA 902403928
Phone: (562) 923-4911
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 10 Open Payments records for all available years, with a total value of $1,680.
Total Amount is formed as General ($1,680) + Research ($0) + Ownership ($0) = $1,680.
Last reported payment date: 2024-09-28 • Largest payer in this snapshot: Smith+Nephew, Inc. ($1,571).
Total Amount
$1,680
General + Research + Ownership
Payments
10
Total payment records
General Amount
$1,680
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $1,571 |
| Fusion Orthopedics USA, LLC | $109 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040614001647 | I | Podiatry | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 84 | 41 | $0 |
| 11721 | Removal of fingernails or toenails, 6 or more nails | 54 | 25 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 92833)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PODIATRY | CA | 11056 | Removal of 2 to 4 thickened skin growths | 251 | 137 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | CA | |
| - | CA | |
| - | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| Physical Therapist In Private Practice | NV | |
| Internal Medicine | CA | |
| - | CA | |
| Internal Medicine, Geriatric Medicine | CA |
Reviews
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