GRACE MIRAN PARK (FNP) – Family Nurse Practitioner, NPI 1811363195
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
Provider Addresses for GRACE MIRAN PARK (FNP)
33507 9TH AVE S STE A
FEDERAL WAY, WA 980036397
Phone: (253) 874-5404
Fax: (253) 874-8964
Type: Location
8511 SOUTH TACOMA WAY #200
Tacoma, WA 984999840
Phone: (253) 588-4015
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 63 Open Payments records for all available years, with a total value of $1,413.
Total Amount is formed as General ($1,413) + Research ($0) + Ownership ($0) = $1,413.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: ABBVIE INC. ($364).
Total Amount
$1,413
General + Research + Ownership
Payments
63
Total payment records
General Amount
$1,413
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $364 |
| GlaxoSmithKline, LLC. | $101 |
| PFIZER INC. | $87 |
| Amgen Inc. | $78 |
| Shield Therapeutics Inc | $71 |
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: 2016-02-05
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 |
|---|---|---|---|---|
| I20160205000186 | 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.
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 | 112 | 67 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 103 | 70 | $0 |
| 99497 | Advance care planning, first 30 minutes | 49 | 48 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 49 | 49 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 34 | 34 | $0 |
Insurance plans in this area (ZIP 98003)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | WA | |
| - | WA | |
| Nurse Practitioner | WA | |
| Internal Medicine | WA | |
| Nurse Practitioner | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| - | WA |
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