Pro Form Sports Medicine and Wellness Associates
NPI 1235432972 · Sports Medicine (Emergency Medicine) Physician · Rutherford, NJ
Pro Form Sports Medicine and Wellness Associates is a Sports Medicine (Emergency Medicine) Physician organization in Rutherford, NJ (NPI 1235432972).
Provider details
- NPI number
- 1235432972
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Emergency Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tae Keun Park, Partner(646) 489-5640
- License
- 25MA08835000 (NJ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-12-20
- Last updated
- 2010-12-20
Frequently asked questions
- What is Pro Form Sports Medicine and Wellness Associates's NPI number?
- Pro Form Sports Medicine and Wellness Associates's National Provider Identifier (NPI) is 1235432972, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pro Form Sports Medicine and Wellness Associates?
- Pro Form Sports Medicine and Wellness Associates is classified in the NPPES registry as Sports Medicine (Emergency Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Pro Form Sports Medicine and Wellness Associates located?
- Pro Form Sports Medicine and Wellness Associates's practice location on file with NPPES is 201 Route 17, Rutherford, NJ 07070-2574.
- What is Pro Form Sports Medicine and Wellness Associates's phone number?
- The practice phone number listed in the NPPES registry for Pro Form Sports Medicine and Wellness Associates is (201) 549-8846.
- Who is the authorized official for Pro Form Sports Medicine and Wellness Associates?
- The authorized official listed on Pro Form Sports Medicine and Wellness Associates's NPPES record is Tae Keun Park, Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pro Form Sports Medicine and Wellness Associates's NPI active?
- Yes — Pro Form Sports Medicine and Wellness Associates's NPI (1235432972) is active in the NPPES registry as of the last update on 2010-12-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.