Individual provider Active NPI

Youjin Park, DPT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1407548787
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61433081 Issued in WA
Practice address
3912 10TH St SE Ste 101
Puyallup, WA 98374-2188
Phone
(253) 848-4700
Fax
(253) 848-2284
NPI assigned
May 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT016291 GA
Physical Therapist 225100000X 40QA02126100 NJ
Physical Therapist 225100000X 1371564 TX
Physical Therapist 225100000X PT61433081 WA Primary

Addresses

Primary practice location

3912 10TH St SE Ste 101
Puyallup, WA 98374-2188

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

4755 S 48th St
Tacoma, WA 98409-1919
Phone (253) 475-4611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA, NJ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231009001289 WA Practitioner - Physical Therapist in Private Practice 4789039900 Reassigns benefits to 1 organization
I20240227003629 CA Practitioner - Physical Therapist in Private Practice 4789039900 Reassigns benefits to 1 organization
I20241230003538 NJ Practitioner - Physical Therapist in Private Practice 4789039900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians
Mobile PhysiocareGroup PAC ID 7416344650, 8 clinicians

Practice addresses (Care Compare)

108 Bilby Rd
Suite 201
Hackettstown, NJ 07840-4174
Phone (908) 684-5646

40 Marquis CT
Edgewater, NJ 07020-2900
Phone (917) 826-7230

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
88.06
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016291GAMDPhysical Therapist
1371564TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists, Inc Physical Therapist CurrentSince Jan 29, 2024 Accepting new patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Dec 23, 2024 Accepting new patients
Mobile Physiocare Physical Therapist CurrentSince Oct 1, 2025 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Dec 23, 2024 Accepting new patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Adi Rehab, Incorporated Physical Therapist PastSince Nov 24, 2019 Accepting new patients

Locations

5359 Balboa Blvd
Ste A
Encino, CA 91316
Phone (818) 506-7821

2730 Wilshire Blvd
Ste 533
Santa Monica, CA 90403
Phone (310) 273-0870

10635 Santa Monica Blvd
Ste 165
West Los Angeles, CA 90025
Phone 3102730877143

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

108 Bilby Rd
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5646

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

3912 10th St SE
#101
Puyallup, WA 98374
Phone (253) 848-4700

Organizations & group practices 7

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1407548787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 10TH ST SE STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-4700",
            "fax_number": "253-848-2284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 S 48th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984091919",
            "country_code": "US",
            "telephone_number": "253-475-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOUJIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016291",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02126100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1371564",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61433081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

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