Active NPI
Joshua Douglas Park, PA-C
- Surgical Physician Assistant
- Cherry Hill, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 25MP00600700
- Practice address
- 1 Brace Rd Ste H
Cherry Hill, NJ 08034 - Phone
- (856) 547-0389
- Fax
- (856) 428-4053
- NPI assigned
- Mar 28, 2007
- Last updated
- Feb 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA051536 | PA | |
| Surgical Physician Assistant | 363AS0400X | 25MP00600700 | NJ | Primary |
Addresses
Primary practice location
1 Brace Rd Ste H
Cherry Hill, NJ 08034
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 355-0340
Other practice location 1
2004 Sproul Rd
Broomall, PA 19008-3511
Phone (610) 353-0800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jpark185260@directvirtua.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Cooper PLZ
Camden, NJ 08103-1461
111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700
150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 630-7000
2 Cooper PLZ
Camden, NJ 08103-1461
3 Cooper PLZ
Camden, NJ 08103-1438
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.23 of 100
- Quality
- 77.64
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 68.41
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00600700 | NJ | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Virtua Medical Group, PA | Current | Accepting new patients | |
| Cooper Surgical Associates, PA | Current | Accepting new patients | |
| Virtua Medical Group, PA | Physician Assistant | Current | Accepting new patients |
| Virtua Medical Group, PA | Past | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
1 Cooper Plz
#A
Camden, NJ 08103
Phone (888) 499-8779
3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270
1 Brace Rd
Ste H
Cherry Hill, NJ 08034
Phone (856) 470-9230
301 Lippincott Dr
Ste 410
Marlton, NJ 08053
700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- jpark121943@direct.cooperhealth.edu
- jpark185260@directvirtua.org
- jpark684918@nyumc.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba NYU Faculty Group Practice
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY
-
- Orthopaedic Surgery Physician
- Voorhees, NJ
- NPI 1427177195
-
- Family Medicine Physician
- Marlton, NJ
- NPI 1649226515
-
- Surgery Physician
- Camden, NJ
- NPI 1649217514
-
- Urgent Care Clinic/Center
- Hammonton, NJ
- NPI 1396342507
-
dba Virtua Reconstructive Orthopedics - Delran
- Orthopaedic Surgery Physician
- Delran, NJ
- NPI 1841087988
Physician Assistant
-
dba NYU Langone Ambulatory Care Chelsea
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- New York, NY
- NPI 1275632895
-
dba NYU Langone Hospital Long Island
- General Acute Care Hospital
- Mineola, NY
- NPI 1427616002
-
- General Acute Care Hospital
- Brooklyn, NY
- NPI 1619341716
-
- General Acute Care Hospital
- New York, NY
- NPI 1669578324
-
- General Acute Care Hospital
- New York, NY
- NPI 1801992631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1457470833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 LIPPINCOTT DR STE 410",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534197",
"telephone_number": "856-355-0340",
"fax_number": "856-355-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BRACE RD STE H",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "08034",
"telephone_number": "856-547-0389",
"fax_number": "856-428-4053"
}
],
"practiceLocations": [
{
"address_1": "2004 Sproul Rd",
"address_purpose": "LOCATION",
"city": "Broomall",
"state": "PA",
"postal_code": "190083511",
"country_code": "US",
"telephone_number": "610-353-0800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "JOSHUA",
"middle_name": "DOUGLAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA051536",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00600700",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jpark185260@directvirtua.org",
"affiliation": "N",
"address_1": "1 Brace Rd Ste H",
"city": "Cherry Hill",
"state": "NJ",
"country_code": "US",
"postal_code": "08034",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.