Individual provider Active NPI

Zhaoyu Jia

  • Physical Therapist
  • Elmhurst, NY
National Provider Identifier
1104369883
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040940 Issued in NY
Practice address
86-09 51St Ave
1St Floor
Elmhurst, NY 11373
Phone
(917) 858-8570
NPI assigned
Nov 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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 040940 NY Primary
Acupuncturist 171100000X 006285 NC

Addresses

Primary practice location

86-09 51St Ave
1St Floor
Elmhurst, NY 11373

Mailing address

4265 Kissena Blvd Apt 517
Flushing, NY 11355-3201
Phone (917) 858-8570

Other practice location 1

132-03 Sanford Ave
suite 1c
Flushing, NY 11355
Phone (718) 961-8881

Other practice location 2

132-03 Sanford Ave
suite 1c
Flushing, NY 11355
Phone (718) 961-8881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114000361 NY Practitioner - Physical Therapist in Private Practice 1355607045 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006285NCMDAcupuncturist
040940NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premium Medical Care, P.C. PastSince Aug 28, 2021 Accepting new patients
Premium Medical Care, PC Past Accepting new patients

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": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1104369883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 KISSENA BLVD APT 517",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553201",
            "telephone_number": "917-858-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86-09 51ST AVE",
            "address_2": "1ST FLOOR",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "917-858-8570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132-03 SANFORD AVE",
            "address_2": "suite 1c",
            "address_purpose": "LOCATION",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "country_code": "US",
            "telephone_number": "718-961-8881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "132-03 SANFORD AVE",
            "address_2": "suite 1c",
            "address_purpose": "LOCATION",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "country_code": "US",
            "telephone_number": "718-961-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIA",
        "first_name": "ZHAOYU",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040940",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "006285",
            "primary": false
        }
    ],
    "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 Aug 27, 2018; 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.