Brandon Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

050567 Issued in NY

Practice address

233 Broadway RM 1775
New York, NY 10279-1810

Phone

(212) 921-7900

NPI assigned

Aug 16, 2023

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

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fuel Physical Therapy & Chiropractic PLLC

  • Physical Therapist
  • New York, NY
  • NPI 1376214767
  Medicare reassignment NPD
• Brandon Park Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • New York, NY
  • NPI 1376354787
  NPD Authorized official

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1356124010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 BROADWAY RM 1775",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102791810",
            "telephone_number": "212-921-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 BROADWAY RM 1775",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102791810",
            "telephone_number": "212-921-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 5th Ave Rm 506",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100177838",
            "country_code": "US",
            "telephone_number": "212-921-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "BRANDON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-16",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Park
• Anthony K. Park, MD
• Aram Park
• Ary Park
• Bernard J. Park, MD
• Brian Edward Park, M.D.
• Bruce Woong Park, L.AC.
• Bumjin Park
• Bumsoo Park, MD
• Byung Joon Park, MD

• 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 Feb 11, 2025; 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.