Park Pain & Rehab Center Inc

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

MD034892E Issued in PA

Legal business name

PARK PAIN & REHAB CENTER INC

Practice address

109 Crossroads Road
Suite 6
Scottdale, PA 15683

Phone

(724) 887-7421

Fax

(724) 887-4145

NPI assigned

Dec 28, 2006

Organization subpart

No

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

Authorized official

Name

John I Park, MD

Title

Medical Doctor Private Practice

Phone

(724) 887-7421

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• John I Park MD Other name

Locations

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1790841674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CROSSROADS ROAD",
            "address_2": "SUITE 6",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "15683",
            "telephone_number": "724-887-7421",
            "fax_number": "724-887-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CROSSROADS ROAD",
            "address_2": "SUITE 6",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "15683",
            "telephone_number": "724-887-7421",
            "fax_number": "724-887-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PAIN & REHAB CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DOCTOR PRIVATE PRACTICE",
        "authorized_official_telephone_number": "724-887-7421",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD034892E",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "MD034892E",
            "primary": false
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "PA",
            "license": "MD034892E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "197526",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011173760007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John I Park MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melissa Myers
• Timothy H Needle, O.D.
• Amanda Nicholson
• Michael Jon Pagliacci, D.C.
• Randall Lee Palmiscno, DMD
• John I Park, M.D.
• Tiffany Pluto, D.O.
• Andrew G Polakovsky, M.D.
• Barbara R. Porter, O.D.
• Premier Dental Alliance LLC (Modern Dental Assoc.)

• Electroneurodiagnostic Specialist/Technologist in Scottdale, PA
• Providers in Scottdale, PA by specialty
• Electroneurodiagnostic Specialist/Technologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.