Donghwan Park

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

041262 Issued in NY

Practice address

42 Broadway Ste 1219
New York, NY 10004-3834

Phone

(917) 592-2207

NPI assigned

Sep 23, 2018

Last updated

Aug 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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

• Donghwan Park Physical Therapy PC

  • Physical Therapist
  • New York, NY
  • NPI 1730774357
  Medicare reassignment Authorized official
• Innovative Rehabilitation Consultant Medical PC

  • Pain Clinic/Center
  • Rego Park, NY
  • NPI 1770880403
  Medicare reassignment NPD
• New York Physical and Occupational Therapy Services, PLLC

  dba New York Therapy And Wellness

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1356703631
  Medicare reassignment NPD
• Wellness of Wall Street Physical Therapy, P.C.

  • Physical Therapist
  • New York, NY
  • NPI 1881401107
  NPD Authorized official
• Fresh Pond Physical Therapy, P.C

  • Physical Therapy Clinic/Center
  • Ridgewood, NY
  • NPI 1508844036
  Medicare reassignment
• Youngsu NA Physical Therapy PC

  • Physical Therapist
  • New York, NY
  • NPI 1548973092
  NPD
• Fresh Pond Physical Therapy Greenpoint, P.C

  • Physical Therapist
  • Ridgewood, NY
  • NPI 1356608509
  NPD (past)

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

{
    "created_epoch": "1537660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1265916423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 BROADWAY STE 1219",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100043834",
            "telephone_number": "917-592-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 BROADWAY STE 1219",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100043834",
            "telephone_number": "917-592-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DONGHWAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-23",
        "last_updated": "2023-08-18",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Park, DPT
• Daniel Park
• Daseul Park
• David C Park, M.D.
• Dodie Jung Min Park
• Elisha Park
• Elizabeth Park, M.D.
• Esther Park, MSOTR/L
• Esther H Park
• Eun Mi Park, D.D.S.

• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.