Individual provider Active NPI

Paul Minseok Tak

  • Acupuncturist
  • Elmhurst, NY
National Provider Identifier
1043631021
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
005178 Issued in NY
Practice address
8655 Broadway Ste C4
Elmhurst, NY 11373-5868
Phone
(201) 966-7828
NPI assigned
Dec 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 005178 NY Primary

Addresses

Primary practice location

8655 Broadway Ste C4
Elmhurst, NY 11373-5868

Mailing address

230 Lexington Ave
Dumont, NJ 07628-1734
Phone (201) 966-7828

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

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Acupuncture PLLC Acupuncturist CurrentSince Feb 4, 2024 Accepting new patients
Luminous Acupuncture PLLC Acupuncturist Current Accepting new patients

Locations

8106 Baxter Ave
Ste MC2
Elmhurst, NY 11373
Phone (718) 639-1110

Organizations & group practices 2

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": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1043631021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 LEXINGTON AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076281734",
            "telephone_number": "201-966-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8655 BROADWAY STE C4",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735868",
            "telephone_number": "201-966-7828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAK",
        "first_name": "PAUL",
        "middle_name": "MINSEOK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.