Jason Yisu Park, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8470 Issued in CO

Practice address

3604 Galley Rd
Suite 200
Colorado Springs, CO 80909-4302

Phone

(719) 550-4613

Fax

(719) 375-8426

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Yi Su Park Former name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quality Rehab IncGroup PAC ID 6406919950, 3 clinicians

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.

• Quality Rehab Inc

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1124276217
  Medicare reassignment Care Compare group NPD Authorized official
• Quality Medical Clinic, LLC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1780288753

  Physical Therapist

  NPD Authorized official
• Quality Rehab Inc

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1992330500
  NPD (past) Authorized official
• Quality Rehab, Inc

  • Physical Therapist
  • Denver, CO
  • NPI 1093558983
  NPD (past) Authorized official
• Quality Health PT&OT

  • Physical Therapist
  • Aurora, CO
  • NPI 1427788769
  NPD (past)
• Quality Health, Inc.

  • Physical Therapist
  • Aurora, CO
  • NPI 1174652580
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1447458369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 GALLEY RD.",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094301",
            "telephone_number": "719-550-4613",
            "fax_number": "719-375-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 GALLEY RD",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809094302",
            "telephone_number": "719-550-4613",
            "fax_number": "719-375-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JASON",
        "middle_name": "YISU",
        "name_prefix": "Mr.",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "8470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42722241",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YI SU",
            "last_name": "PARK",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monice Lashay Paris
• Taylor Parisse, D.O.
• Park Ave Apothecary LLC
• Park Ave Apothecary LLC
• Jason Andrew Park
• Jessica Park, LPCC
• Kwang-Soo Park, MD
• Tanya Rachel Park, CPM
• John Parkanzky
• Stacey Marie Parker-Brueggemann, M.D.

• Physical Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.