Individual provider Active NPI

Sejin Park, DPT

  • Physical Therapist
  • Bellevue, WA
National Provider Identifier
1679149132
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61585752 Issued in WA
Practice address
3101 Northup Way Ste 101
Bellevue, WA 98004-1435
Phone
(425) 462-5006
Fax
(425) 462-5019
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61585752 WA Primary

Addresses

Primary practice location

3101 Northup Way Ste 101
Bellevue, WA 98004-1435

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 462-5006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210730000124 NJ Practitioner - Physical Therapist in Private Practice 9537562343 Reassigns benefits to 2 organizations
I20250225002105 WA Practitioner - Physical Therapist in Private Practice 9537562343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

3101 Northup Way
Suite 101
Bellevue, WA 98004-1469
Phone (425) 462-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT61585752WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Lee Physical Therapy, P.C. Physical Therapist CurrentSince Jun 13, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 14, 2021 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Mar 3, 2025 Accepting new patients
Proliance Surgeons Inc., P.S. Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Jun 14, 2021 Accepting new patients

Locations

590 Anderson Ave
Cliffside Pk, NJ 07010
Phone (201) 941-8667

2050 Center Ave
Ste 375
Fort Lee, NJ 07024
Phone (201) 564-0691

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

576 Broadhollow Rd
Melville, NY 11747

3101 Northup Way
Ste 101
Bellevue, WA 98004
Phone (425) 462-5006

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

510 8th Ave NE
Ste 320
Issaquah, WA 98029

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1679149132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 NORTHUP WAY STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041435",
            "telephone_number": "425-462-5006",
            "fax_number": "425-462-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SEJIN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61585752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.