SAMUEL PARK PT, DPT
NPI 1861319196
Physical Therapist in San Bernardino, CA
About Samuel Park Pt, Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL PARK PT, DPT (NPI 1861319196) is an individual physical therapist in San Bernardino, California and active in the NPI registry since June 2026. He maintains a secondary practice location in West Covina and is a graduate of Other (2025).
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.
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samuel Park Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samuel Park reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Bernardino, CA 92408
- Reassigned Medicare billing, California enrollment
- 39 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.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN BERNARDINO, CA 92408
SAN BERNARDINO, CA 92408
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 Samuel Park's NPI number?
The NPI number for Samuel Park is 1861319196. It was assigned to this individual provider in the NPPES registry on June 29, 2026.
Where is Samuel Park located?
Samuel Park practices at 275 W Hospitality Ln Ste 100, San Bernardino, CA 92408. The listed phone number is (909) 567-2221.
What is Samuel Park's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Samuel Park enrolled in Medicare?
Yes. Samuel Park is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Samuel Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Park reassigns Medicare benefits to Transit Physical Therapy PC (San Bernardino, CA). The 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 Samuel 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 Samuel Park was last updated on June 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.