DR. JONATHAN PARK (MD) – Family Medicine Physician, NPI 1205324969
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
Provider Addresses for DR. JONATHAN PARK (MD)
8876 MISSION BLVD
JURUPA VALLEY, CA 925092811
Phone: (951) 360-8795
Type: Mailing
14350, Meridian Parkway, Riverside County, California, 92518, United States
RIVERSIDE, CA 925183035
Phone: (951) 827-7669
Fax: (951) 827-4280
Type: Mailing
UC San Diego Medical Center, 200, West Arbor Drive, Hillcrest, San Diego, San Diego County, California, 92103, United States
SAN DIEGO, CA 921039000
Phone: (619) 543-6268
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $377.
Total Amount is formed as General ($377) + Research ($0) + Ownership ($0) = $377.
Last reported payment date: 2024-09-27 • Largest payer in this snapshot: Balt USA, LLC ($240).
Total Amount
$377
General + Research + Ownership
Payments
4
Total payment records
General Amount
$377
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Balt USA, LLC | $240 |
| Otsuka America Pharmaceutical, Inc. | $122 |
| Ultragenyx Pharmaceutical Inc. | $15 |
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: 2021-05-13
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 |
|---|---|---|---|---|
| I20210513002426 | I | Family Practice | 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 |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 23 | 11 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 23 | 23 | $0 |
| 87807 | Detection test by immunoassay with direct visual observation for respiratory syncytial virus | 15 | 13 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 13 | 12 | $0 |
Insurance plans in this area (ZIP 92509)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| Family Practice | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| - | CA | |
| P S Y C H I A T R Y | CA | |
| Internal Medicine, Infectious Disease | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Nurse Practitioner | CA |
Reviews
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