Individual provider Active NPI

Eunyoung Lee

  • Physical Therapist
  • Bronx, NY
National Provider Identifier
1013450832
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032405 Issued in NY
Practice address
2825 3Rd Ave
4TH Floor
Bronx, NY 10455-4066
Phone
(718) 401-3000
Fax
(718) 292-8610
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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 032405 NY Primary

Addresses

Primary practice location

2825 3Rd Ave
4TH Floor
Bronx, NY 10455-4066

Mailing address

4346 165TH St
Flushing, NY 11358-3227
Phone (718) 414-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180430000234 NY Practitioner - Physical Therapist in Private Practice 1052675006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Park Physical Medicine and Rehabilitation P.C.Group PAC ID 1759294135, 9 clinicians

Practice addresses (Care Compare)

2 W 86TH St
Apt 1
New York, NY 10024-3625
Phone 2129571930111

2825 3Rd Ave
Apt 4
Bronx, NY 10455-4068
Phone 2129571930111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
032405NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Park Physical Medicine and Rehabilitation P.C. CurrentSince May 3, 2018 Accepting new patients

Locations

2825 3rd Ave
Apt 4
Bronx, NY 10455
Phone (212) 447-0300

2825 3rd Ave
Fl 4
Bronx, NY 10455
Phone (718) 401-3000

10 E 39th St
Fl 3
New York, NY 10016
Phone (212) 447-0300

265 W 37th St
Rm 660
New York, NY 10018

Organizations & group practices 1

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": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1013450832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 165TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583227",
            "telephone_number": "718-414-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 3RD AVE",
            "address_2": "4TH FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104554066",
            "telephone_number": "718-401-3000",
            "fax_number": "718-292-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EUNYOUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032405",
            "primary": true
        }
    ],
    "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 Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.