Individual provider Active NPI

Theresa Jaehee Hwang, D.P.T.

  • Physical Therapist
  • Scarsdale, NY
National Provider Identifier
1023033289
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022048 Issued in NY
Practice address
1075 Central Park Ave Ste 407
Scarsdale, NY 10583-3232
Phone
(914) 214-9220
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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 022048 NY Primary

Addresses

Primary practice location

1075 Central Park Ave Ste 407
Scarsdale, NY 10583-3232

Mailing address

1075 Central Park Ave Ste 407
Scarsdale, NY 10583-3232
Phone (914) 214-9220

Other identifiers 1

IdentifierTypeStateIssuer
05238555MedicaidNY

Other names 1

  • Theresa Jaehee Fowler Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150325001014 NY Practitioner - Physical Therapist in Private Practice 2668424607 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1075 Central Park Ave
Suite 407
Scarsdale, NY 10583-3232
Phone (914) 214-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022043NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Sports and Spinal Physical Therapy, PLLC CurrentSince Sep 6, 2017 Accepting new patients
Edgemont Physical Therapy, P.C. CurrentSince Jul 1, 2019 Accepting new patients
Recoup Physical Therapy, PLLC Physical Therapist CurrentSince Jul 9, 2019 Accepting new patients
Christine L Spryer Physical Therapist PastSince Oct 22, 2001 Accepting new patients

Locations

838 Scarsdale Ave
Scarsdale, NY 10583
Phone (914) 722-9200

455 Central Park Ave
Scarsdale, NY 10583
Phone (914) 574-6494

1075 Central Park Ave
Ste 407
Scarsdale, NY 10583
Phone (914) 214-9220

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1023033289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 CENTRAL PARK AVE STE 407",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833232",
            "telephone_number": "914-214-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 CENTRAL PARK AVE STE 407",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833232",
            "telephone_number": "914-214-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "THERESA",
        "middle_name": "JAEHEE",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05238555",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "FOWLER",
            "middle_name": "JAEHEE",
            "credential": "D.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.