Individual provider Active NPI

Eddie Wong, PT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1013928662
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027635-1 Issued in NY
Practice address
185 Montague St
6TH Floor
Brooklyn, NY 11201-3608
Phone
(718) 243-9900
Fax
(718) 243-1620
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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 027635-1 NY Primary

Addresses

Primary practice location

185 Montague St
6TH Floor
Brooklyn, NY 11201-3608

Mailing address

2117 E 27TH St
Brooklyn, NY 11229-5011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000697 NY Practitioner - Physical Therapist in Private Practice 0941215974 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027635-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Better Yourself Rehabilitation Physical and Occupational Therapy, PLLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Prime Fitness and Wellness Inc Physical Therapist CurrentSince Sep 25, 2024 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients

Locations

455 N End Ave
Bsmt
New York, NY 10282
Phone (646) 470-8615

Organizations & group practices 3

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1013928662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 E 27TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112295011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MONTAGUE ST",
            "address_2": "6TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013608",
            "telephone_number": "718-243-9900",
            "fax_number": "718-243-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "EDDIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027635-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.