PETER S PARK (FNP) – Nurse Practitioner, NPI 1154937241
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
Provider Addresses for PETER S PARK (FNP)
1003 WALLACE WAY
GRANDVIEW, WA 989308805
Phone: (509) 203-1080
Type: Mailing
820 MEMORIAL ST STE 1
PROSSER, WA 993502504
Phone: (509) 786-2010
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 54 Open Payments records for all available years, with a total value of $1,304.
Total Amount is formed as General ($1,304) + Research ($0) + Ownership ($0) = $1,304.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($438).
Total Amount
$1,304
General + Research + Ownership
Payments
54
Total payment records
General Amount
$1,304
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 |
|---|---|
| AstraZeneca Pharmaceuticals LP | $438 |
| ABBVIE INC. | $413 |
| Novo Nordisk Inc | $116 |
| Daiichi Sankyo Inc. | $59 |
| Bayer Healthcare Pharmaceuticals Inc. | $58 |
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: 2021-02-12
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 |
|---|---|---|---|---|
| I20210212002122 | I | Nurse Practitioner | WA | 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 98930)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | AZ | |
| Family Practice | WA | |
| Nurse Practitioner | WA | |
| Certified Nurse Midwife (Cnm) | WA | |
| Family Practice | WA | |
| N E P H R O L O G Y | WA | |
| Geriatric Medicine | WA | |
| Internal Medicine | IN | |
| Cardiovascular Disease (Cardiology) | WA | |
| Nurse Practitioner | OH |
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