Individual provider Active NPI

Seonjoong Lee

  • Physical Therapist
  • New York, NY
National Provider Identifier
1003546540
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040285 Issued in NY
Practice address
150 E 55TH St FRNT 1
New York, NY 10022-4514
Phone
(201) 815-3969
NPI assigned
Jun 16, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040285 NY Primary

Addresses

Primary practice location

150 E 55TH St FRNT 1
New York, NY 10022-4514

Mailing address

251 W 74TH St Apt 7a
New York, NY 10023-2140
Phone (201) 815-3969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116003224 NY Practitioner - Physical Therapist in Private Practice 9931551819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040285NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grit Core Physical Therapy P.C. Physical Therapist CurrentSince Sep 3, 2025 Accepting new patients
Grit Life Physical Therapy P.C. Physical Therapist Current Accepting new patients
Lenox Hill Pain Management and Spine PLLC CurrentSince Dec 12, 2023 Accepting new patients
Grit Wellness Rehabilitation Physical Therapy P.C. CurrentSince Feb 1, 2023 Accepting new patients
Karan Johar, MD, PLLC PastSince Dec 12, 2023 Accepting new patients

Locations

4212 164th St
Fl 1
Flushing, NY 11358
Phone (718) 701-5500

13338 41st Rd
Ste CS8
Flushing, NY 11355
Phone (718) 321-0886

150 E 55th St
Frnt 1
New York, NY 10022
Phone (201) 815-3969

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1003546540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 W 74TH ST APT 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232140",
            "telephone_number": "201-815-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E 55TH ST FRNT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224514",
            "telephone_number": "201-815-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SEONJOONG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-16",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.