Joseph Park, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

39588 Issued in CA

Practice address

12465 Lewis Street
Suite 101
Garden Grove, CA 92840-4658

Phone

(714) 703-8477

Fax

(714) 703-8157

NPI assigned

Nov 16, 2012

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Physical Therapy IncGroup PAC ID 5597071860, 9 clinicians

Ascend Laguna Woods Physical Therapy IncGroup PAC ID 2769927482, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Ascend Laguna Woods Physical Therapy, Inc

  • Physical Therapist
  • Laguna Woods, CA
  • NPI 1265291124
  Medicare reassignment Care Compare group NPD Authorized official
• Ascend Physical Therapy, Inc

  • Physical Therapist
  • Garden Grove, CA
  • NPI 1184015943
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1760726574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS STREET",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12465 LEWIS STREET",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JOSEPH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiwon Park
• Joanne Eunjin Park
• Jongsook Susie Park, MD
• Joo Ae Park, AMFT, RN
• Joonkyu Park, D.C.
• Jun Gyu Park, DDS
• Kideog Park
• Sanghoon Park, DDS
• Seonho Park
• Serena Park

• Physical Therapist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.