EUGENE PARK (L.AC, PA-C) – Physician Assistant, NPI 1154472546
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,576 PHYSICIAN ASSISTANT in NJ
Provider Addresses for EUGENE PARK (L.AC, PA-C)
458 WEST ST
FORT LEE, NJ 070243408
Phone: (201) 474-7700
Type: Location
7601, East Imperial Highway, Downey, Los Angeles County, California, 90242, United States
DEPARTMENT OF SURGERY
DOWNEY, CA 90242
Phone: (562) 401-7166
Fax: (714) 649-5268
Type: Mailing
24A E EDSALL BLVD
PALISADES PARK, NJ 076503626
Phone: (323) 304-4832
Type: Mailing
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 $109.
Total Amount is formed as General ($109) + Research ($0) + Ownership ($0) = $109.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($64).
Total Amount
$109
General + Research + Ownership
Payments
4
Total payment records
General Amount
$109
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $64 |
| PFIZER INC. | $45 |
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: 2020-10-26
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 |
|---|---|---|---|---|
| I20201014000153 | I | Physician Assistant | NJ | TBD |
| I20201026000661 | I | Physician Assistant | NY | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07024)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | NJ | |
| Physician Assistant | NJ | |
| Physician Assistant | NJ | |
| Physician Assistant | PA | |
| Physician Assistant | NJ | |
| Physician Assistant | NJ | |
| Physician Assistant | CA | |
| Physician Assistant | NY | |
| Physician Assistant | NJ | |
| Physician Assistant | NJ |
Reviews
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