DONGHWAN PARK
NPI 1265916423
Physical Therapist in New York, NY
About Donghwan Park NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DONGHWAN PARK (NPI 1265916423) is an individual physical therapist in New York, New York, licensed in New York (041262) and active in the NPI registry since September 2018.
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Donghwan Park is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Donghwan Park reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
New York, NY 10004
- Reassigned Medicare billing, New York enrollment
Ridgewood, NY 11385
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Fresh Pond Physical Therapy PC
- 34 clinicians in this Medicare group
Brooklyn, NY 11229
- Reassigned Medicare billing, New York enrollment
- 446 clinicians in this Medicare group
Rego Park, NY 11374
- Reassigned Medicare billing, New York enrollment
- 7 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10004
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Donghwan Park's NPI number?
The NPI number for Donghwan Park is 1265916423. It was assigned to this individual provider in the NPPES registry on September 23, 2018.
Where is Donghwan Park located?
Donghwan Park practices at 42 Broadway Ste 1219, New York, NY 10004. The listed phone number is (917) 592-2207.
What is Donghwan Park's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Donghwan Park enrolled in Medicare?
Yes. Donghwan Park is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Donghwan Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Donghwan Park reassigns Medicare benefits to 4 organizations: Donghwan Park Physical Therapy PC (New York, NY), Fresh Pond Physical Therapy, P.C (Ridgewood, NY), New York Physical And Occupational Therapy Services, PLLC (Brooklyn, NY) and Innovative Rehabilitation Consultant Medical PC (Rego Park, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Donghwan Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Donghwan Park was last updated on August 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.