DR. SAMUEL K. PARK (M.D.) – Family Medicine Physician, NPI 1497832661
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
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Provider Addresses for DR. SAMUEL K. PARK (M.D.)
Southwest Birch Street, Upper Bay, Newport Beach, Orange County, California, 92660, United States
NEWPORT BEACH, CA 926600794
Phone: (949) 757-1150
Fax: (949) 757-1170
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $31.
Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.
Last reported payment date: 2024-08-15 • Largest payer in this snapshot: Mylan Specialty L.P. ($18).
Total Amount
$31
General + Research + Ownership
Payments
2
Total payment records
General Amount
$31
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Mylan Specialty L.P. | $18 |
| Exact Sciences Corporation | $13 |
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: 2018-11-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20120504000528 | I | Family Practice | CA | TBD |
| I20181114000933 | I | Family Practice | IA | 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 | 153 | 118 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 91 | 78 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 40 | 36 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 11 | 11 | $0 |
Insurance plans in this area (ZIP 92660)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MO | |
| - | MN | |
| Nurse Practitioner | IA | |
| Physician Assistant | MN | |
| Nurse Practitioner | IA |
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