Individual provider Active NPI

Yohan Park, DPT

  • Physical Therapist
  • Ann Arbor, MI
National Provider Identifier
1942066121
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501303247 Issued in MI
Practice address
58 Parkland PLZ Ste 100
Ann Arbor, MI 48103-6208
Phone
(734) 222-8515
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 5501303247 MI Primary

Addresses

Primary practice location

58 Parkland PLZ Ste 100
Ann Arbor, MI 48103-6208

Mailing address

4756 Greenfield Dr
Berrien Springs, MI 49103-9554
Phone (269) 277-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306002339 MI Practitioner - Physical Therapist in Private Practice 5597101162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healing Hands Therapy LTDGroup PAC ID 6608855747, 15 clinicians

Practice addresses (Care Compare)

58 Parkland PLZ
Suite 100
Ann Arbor, MI 48103-6208
Phone (734) 222-8515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501303247MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Therapy LTD Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Wisconsin Orthopedic Physical Therapy Physical Therapist PastSince Jun 23, 2024 Accepting new patients

Locations

58 Parkland Plz
Ste 100
Ann Arbor, MI 48103
Phone (734) 222-8515

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1942066121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4756 GREENFIELD DR",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491039554",
            "telephone_number": "269-277-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 PARKLAND PLZ STE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036208",
            "telephone_number": "734-222-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "YOHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.