MR. RYAN PARK (NP) – Nurse Practitioner, NPI 1760738728
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,798 NURSE PRACTITIONER in ID
Provider Addresses for MR. RYAN PARK (NP)
360 E Montvue Dr. Ste 100
Meridian, ID 83642
Phone: (208) 855-2900
Fax: (208) 898-9877
Type: Location
1021 Cesery Blvd
Jacksonville, FL 322115609
Phone: (904) 743-2466
Type: Location
57 Town Ct Ste 123
Palm Coast, FL 321642425
Phone: (904) 230-3006
Fax: (877) 638-8891
Type: Location
1105 2ND ST S
STE 100
NAMPA, ID 836513911
Phone: (480) 862-1677
Fax: (480) 718-7643
Type: Mailing
360 E MONTVUE DR. STE 100
MERIDIAN, ID 83642
Phone: (208) 855-2900
Fax: (208) 898-9877
Type: Location
559 W TWINCOURT TRL STE 607-608
SAINT AUGUSTINE, FL 320958805
Phone: (904) 230-3006
Fax: (877) 638-8891
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $2,514.
Total Amount is formed as General ($2,514) + Research ($0) + Ownership ($0) = $2,514.
Last reported payment date: 2024-11-15 • Largest payer in this snapshot: Relievant Medsystems, Inc. ($1,045).
Total Amount
$2,514
General + Research + Ownership
Payments
77
Total payment records
General Amount
$2,514
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Relievant Medsystems, Inc. | $1,045 |
| Boston Scientific Corporation | $231 |
| Medtronic, Inc. | $153 |
| Kyowa Kirin, Inc. | $127 |
| PAINTEQ LLC | $120 |
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: 2024-05-11
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 |
|---|---|---|---|---|
| I20240511000036 | I | Nurse Practitioner | FL | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 246 | 80 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 36 | 13 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 16 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 12 | $0 |
Insurance plans in this area (ZIP 83642)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | FL | |
| Physician Assistant | FL | |
| Physician Assistant | WA | |
| - | FL | |
| Family Practice | FL | |
| - | PA | |
| - | FL | |
| - | FL | |
| Physician Assistant | FL | |
| - | FL |
Reviews
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