Active Movement Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ACTIVE MOVEMENT PHYSICAL THERAPY PC

Practice address

370 Lexington Ave RM 312
New York, NY 10017-6564

Phone

(212) 286-9800

Fax

(212) 286-9801

NPI assigned

Dec 7, 2018

Organization subpart

No

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

Authorized official

Name

Kyoungtae Lee, DR.NPI 1912449547

Title

Physical Therapist

Phone

(929) 333-4564

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyoungtae Lee

  • Physical Therapist
  • New York, NY
  • NPI 1912449547
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1053882613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LEXINGTON AVE RM 312",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176564",
            "telephone_number": "212-286-9800",
            "fax_number": "212-286-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LEXINGTON AVE RM 312",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176564",
            "telephone_number": "212-286-9800",
            "fax_number": "212-286-9801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Fulton Ave Ste 503",
            "address_purpose": "LOCATION",
            "city": "Hempstead",
            "state": "NY",
            "postal_code": "115503702",
            "country_code": "US",
            "telephone_number": "929-333-4564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACTIVE MOVEMENT PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-07",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KYOUNGTAE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "929-333-4564",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in New York, NY
• Providers in New York, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.