Individual provider Active NPI

Hannah J Park, DPT

  • Physical Therapist
  • La Crescenta, CA
National Provider Identifier
1114397627
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293806 Issued in CA
Practice address
3151 Fairmount Ave
La Crescenta, CA 91214-2625
Phone
(323) 303-6811
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 293806 CA Primary

Addresses

Primary practice location

3151 Fairmount Ave
La Crescenta, CA 91214-2625

Mailing address

3151 Fairmount Ave
La Crescenta, CA 91214-2625
Phone (323) 303-6811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620000476 CA Practitioner - Physical Therapist in Private Practice 6002195559 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039380NYMDDentist
293806CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flintridge Physical Therapy Physical Therapist CurrentSince Feb 17, 2024 Accepting new patients
Momentum Physical Therapy Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist CurrentSince Dec 1, 2024 Accepting new patients
Fitness Philosophy, LLC Physical Therapist PastSince Apr 1, 1999 Accepting new patients

Locations

11500 W Olympic Blvd
Ste 470
Los Angeles, CA 90064
Phone (310) 473-8287

2520 Honolulu Ave
Ste 150
Montrose, CA 91020
Phone (747) 255-7072

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1114397627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 FAIRMOUNT AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142625",
            "telephone_number": "323-303-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 FAIRMOUNT AVE",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912142625",
            "telephone_number": "323-303-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HANNAH",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crescenta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.