Sue Jin Park, RN in Bishop, CA - Medicare Registered Nurse

Sue Jin Park, RN is a medicare enrolled "Registered Nurse - General Practice" in Bishop, California. Her current practice location is 1360 N Main St Ste 124, Bishop, California. You can reach out to her office (for appointments etc.) via phone at (760) 873-6533.

Sue Jin Park is licensed to practice in California (license number 840776) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1952813826.

Contact Information

	Sue Jin Park, RN
	1360 N Main St Ste 124, Bishop, CA 93514-3013
	(760) 873-6533
	(760) 873-3277

Map and Direction

Provider's Profile

Full Name	Sue Jin Park
Gender	Female
Speciality	Registered Nurse - General Practice
Location	1360 N Main St Ste 124, Bishop, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1952813826
Provider Enumeration Date: 10/31/2017
Last Update Date: 01/27/2022

Medicare PECOS Information:

PECOS PAC ID: 8426315938
Enrollment ID: I20171207002024

Medical Identifiers

Medical identifiers for Sue Jin Park such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952813826	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95005086 (California)	Secondary
163WG0000X	Registered Nurse - General Practice	840776 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sue Jin Park allows following entities to bill medicare on her behalf.

Entity Name	Northern Inyo Healthcare District
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922198712 PECOS PAC ID: 8921992090 Enrollment ID: O20040210000652

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sue Jin Park is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Sue Jin Park, RN 1360 N Main St Ste 124, Bishop, CA 93514-3013 Ph: (760) 873-6533	Sue Jin Park, RN 1360 N Main St Ste 124, Bishop, CA 93514-3013 Ph: (760) 873-6533

Reviews and Comments

Registered Nurse Nurses in Bishop, CA

Cindy Dixon, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533 Fax: 760-873-3277
Anita Richardson, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533 Fax: 760-873-3277
Dena Laurice Dondero, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 52 Tu Su Lane, Bishop, CA 93514 Phone: 760-873-8464 Fax: 760-873-3935
Margo Marie Lella, APRN, FNP Registered Nurse Medicare: Medicare Enrolled Practice Location: 52 Tu Su Lane, Bishop, CA 93514 Phone: 760-873-8464 Fax: 760-873-3935
Ms. Stephanie Danielle Selke, FNP-C Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 250 N See Vee Lane, Bishop, CA 93514 Phone: 760-873-8461 Fax: 760-873-3935
Michelle Jacqueline Noxsel, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 250 N See Vee Ln, Bishop, CA 93514 Phone: 760-873-8461 Fax: 760-503-4174
Mrs. Connie Lou Connolly, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533

Sue Jin Park, RN - Medicare Registered Nurse in Bishop, CA