Jason Hyuk Park, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24454 Issued in CA

Practice address

4482 Barranca Pkwy
Suite 195
Irvine, CA 92604-7701

Phone

(949) 679-3337

Fax

(949) 679-3336

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Southern California Keck School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland Physical Therapy IncGroup PAC ID 9234297771, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Southland Physical Therapy, Inc.

  • Physical Therapist
  • Irvine, CA
  • NPI 1710150172
  Medicare reassignment Care Compare group NPD Authorized official
• Reach Physical Therapy Network

  • Physical Therapist
  • Santa Ana, CA
  • NPI 1689337818
  NPD
• Therapro

  • Geriatric Physical Therapist
  • San Clemente, CA
  • NPI 1518919638
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1053370239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY",
            "address_2": "SUITE 195",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047701",
            "telephone_number": "949-679-3337",
            "fax_number": "949-679-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY",
            "address_2": "SUITE 195",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926047701",
            "telephone_number": "949-679-3337",
            "fax_number": "949-679-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JASON",
        "middle_name": "HYUK",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT24454",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "0PT244540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "AR052",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "PT24454",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Park
• Eunice Park
• Eunyung Park, DDS
• Hyungwook Park
• Jae H Park, D.C.
• Jennifer Park, LMFT
• Jin Hee Park, L.AC.
• Jin Joo Park
• Jiyeon Park, PHD, LAC
• Joann Park

• Physical Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.