Bayside Professional PT PC
NPI 1730054362ActiveOrganization· Physical Therapist· Bayside, NY
Physical Therapist in Bayside, New York, registered in NPPES in October 2025. The authorized official on file is Jaehyun Park, DPT, Physical Therapist/Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1730054362 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 6, 2025 |
| Last updated in NPPES | Oct 6, 2025 |
| Certified by provider | Oct 6, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (NY) |
|---|
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