Individual provider Active NPI

Myung Hun Lee, RPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1053671412
Registry record updated May 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
031828 Issued in NY
Practice address
835 61St St
Brooklyn, NY 11220-4312
Phone
(718) 854-8869
Fax
(718) 854-8861
NPI assigned
May 19, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2012

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 031828 NY Primary

Addresses

Primary practice location

835 61St St
Brooklyn, NY 11220-4312

Mailing address

14945 Northern Blvd
Apt #4-O
Flushing, NY 11354-3897
Phone (718) 854-8869

Other identifiers 1

IdentifierTypeStateIssuer
031828OtherNYLICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
031828NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
8TH Ave Physical Therapy PC Physical Therapist Past Accepting new patients

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": "1337385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337385600000",
    "number": "1053671412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14945 NORTHERN BLVD",
            "address_2": "APT #4-O",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543897",
            "telephone_number": "718-854-8869",
            "fax_number": "718-854-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 61ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204312",
            "telephone_number": "718-854-8869",
            "fax_number": "718-854-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNG HUN",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-19",
        "last_updated": "2012-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "031828",
            "state": "NY"
        }
    ],
    "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 May 19, 2012; 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.