Individual provider Active NPI

Bongyong Choi

  • Physical Therapist
  • Little Neck, NY
National Provider Identifier
1073076568
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
24825 Northern Blvd Ste 2B
Little Neck, NY 11362-1280
Phone
(347) 235-4742
Fax
(718) 691-4366
NPI assigned
Apr 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

24825 Northern Blvd Ste 2B
Little Neck, NY 11362-1280

Mailing address

24825 Northern Blvd Ste 2B
Little Neck, NY 11362-1280
Phone (909) 567-3870

Other practice location 1

3901 Main St Ste 310
Flushing, NY 11354-5434
Phone (917) 563-1373

Other identifiers 1

IdentifierTypeStateIssuer
571812731OtherNYDRIVER LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200415002837 NY Practitioner - Physical Therapist in Private Practice 9931536505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24825 Northern Blvd
Suite 2B
Little Neck, NY 11362-1280
Phone (347) 235-4742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039509NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Seoul Physical Therapy Physical Therapist Current Accepting new patients
Seoul Physical Therapy P.C Physical Therapist CurrentSince Jun 20, 2024 Accepting new patients

Locations

24825 Northern Blvd
Ste 2B
Little Neck, NY 11362
Phone (347) 235-4742

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1073076568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24825 NORTHERN BLVD STE 2B",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621280",
            "telephone_number": "909-567-3870",
            "fax_number": "718-691-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24825 NORTHERN BLVD STE 2B",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621280",
            "telephone_number": "347-235-4742",
            "fax_number": "718-691-4366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Main St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545434",
            "country_code": "US",
            "telephone_number": "917-563-1373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "BONGYONG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "571812731",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.