Andrew Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60691657 Issued in WA

Practice address

9900 Indiana Ave Ste 8
Riverside, CA 92503-5498

Phone

(951) 376-1120

NPI assigned

Nov 16, 2016

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment Care Compare group NPD
• Fairbanks & Power Physical Therapy Corp.

  dba PacificPro Physical Therapy & Sports Medicine

  • Physical Therapist
  • Irvine, CA
  • NPI 1912953936
  Medicare reassignment NPD
• Northwest Center for Sports Medicine & Physical Therapy, Inc.

  dba Northwest Sports Physical Therapy

  • Physical Therapist
  • Gig Harbor, WA
  • NPI 1982755070
  NPD (past)

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1437691870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 KIRK ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064636",
            "telephone_number": "253-431-8046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 INDIANA AVE STE 8",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035498",
            "telephone_number": "951-376-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-16",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60691657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "60691657",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT304206",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Pari
• Michael C Parillo, D.C.
• Leanna M Parisi, OD
• Park and Park Dental Group Partnership (Smile Builder)
• Amy Leanne Park, O.D.
• Andrew Min Park, D.C.
• Anthony J Park, MD
• Eunkyung Park, L.AC
• Hannah Park
• Hanseul Park, DDS

• Physical Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.