Active NPI
Youngsik Jeong, L.AC
- Physical Therapist
- Bronx, NY
National Provider Identifier
1003501982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 055493-01
- Practice address
- 3060 E Tremont Ave
Bronx, NY 10461-5726 - Phone
- (718) 931-0818
- NPI assigned
- Apr 6, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 055493-01 | NY | Primary |
| Acupuncturist | 171100000X | 7261 | NY |
Addresses
Primary practice location
3060 E Tremont Ave
Bronx, NY 10461-5726
Mailing address
19780F Peck Ave
Fresh Meadows, NY 11365-2878
Phone (929) 383-3192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7261 | NY | MD | Acupuncturist |
| 055493-01 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1003501982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19780F PECK AVE",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113652878",
"telephone_number": "929-383-3192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3060 E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104615726",
"telephone_number": "718-931-0818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "YOUNGSIK",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-06",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "055493-01",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "7261",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.