Individual provider Active NPI

Catherina Jihyun Park, PT, DPT

  • Physical Therapist
  • Rockville, MD
National Provider Identifier
1275216970
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29604 Issued in MD
Practice address
26 Maryland Ave
Rockville, MD 20850-0350
Phone
(833) 493-4325
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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 29604 MD Primary

Addresses

Primary practice location

26 Maryland Ave
Rockville, MD 20850-0350

Mailing address

26 Maryland Ave
Rockville, MD 20850-0350
Phone (833) 493-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230925000886 DC Practitioner - Physical Therapist in Private Practice 1658725718 Reassigns benefits to 1 organization
I20231026002477 MD Practitioner - Physical Therapist in Private Practice 1658725718 Reassigns benefits to 1 organization
I20240707000042 VA Practitioner - Physical Therapist in Private Practice 1658725718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

172 Linden Dr
Suite 100
Winchester, VA 22601-2892
Phone (540) 722-8172

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29604MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

26 Maryland Ave
Rockville, MD 20850
Phone (833) 439-4325

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

8644 Sudley Rd
#220
Manassas, VA 20110

172 Linden Dr
Ste 100
Winchester, VA 22601
Phone (540) 722-8172

Interoperability endpoints

  • Direct secure messaging: catherina.park.1@8042.direct.athenahealth.com

Organizations & group practices 2

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": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1275216970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MARYLAND AVE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208500350",
            "telephone_number": "833-493-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MARYLAND AVE",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208500350",
            "telephone_number": "833-493-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CATHERINA",
        "middle_name": "JIHYUN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.