David Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01628700 Issued in NJ

Practice address

158 Linwood PLZ Ste 308
Fort Lee, NJ 07024-3704

Phone

(201) 461-9333

NPI assigned

Aug 26, 2015

Last updated

Oct 30, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Equilibrium LLCGroup PAC ID 7315256906, 4 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.

• Equilibrium, LLC

  • Physical Therapist
  • Fort Lee, NJ
  • NPI 1710383419
  Medicare reassignment Care Compare group NPD Authorized official
• Gradus Physiotherapy PT PLLC

  • Physical Therapist
  • New York, NY
  • NPI 1265243398
  NPD Authorized official

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1689041659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 LINWOOD PLZ STE 308",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243704",
            "telephone_number": "201-461-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 LINWOOD PLZ STE 308",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070243704",
            "telephone_number": "201-461-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-26",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01628700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palisades Surgical Suites, LLC
• Palisdes Periodontics
• Elizabeth Palughi
• Chang S Park, M.D.
• Clara Park, DDS
• David Spring Park, LAC
• Eugene Park, L.AC, PA-C
• Haeri Park
• Hyewon Park
• Hyun Joo Park, DPT

• Physical Therapist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; 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.