Jung Chul Park

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01658400 Issued in NJ

Practice address

2447 Rossett St FL 1
Fort Lee, NJ 07024-3919

Phone

(201) 757-7234

NPI assigned

Mar 8, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jungchul.park.p27@direct.medcor.nextgenshare.com

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.

• Elevate PT LLC

  • Physical Therapy Clinic/Center
  • Fort Lee, NJ
  • NPI 1487113981

  Physical Therapist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1134580988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 ROSSETT ST FL 1",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 ROSSETT ST FL 1",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243919",
            "telephone_number": "201-757-7234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 OAK ST",
            "address_2": "APT 4",
            "address_purpose": "LOCATION",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014932",
            "country_code": "US",
            "telephone_number": "201-488-0488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG CHUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-08",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01658400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Insun Park, D.C.
• Jaesung Park, DC
• Jeong In Park, PHARMACIST
• Jihye Park, DDS
• Jonghee Park
• Margaret Chu Park, D.M.D.
• Samue C. Park, D.C.
• Sara Park
• Shul Hyung Park, R.PH
• Soui Park

• Physical Therapist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.