Samuel Yoo Physical Therapy PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SAMUEL YOO PHYSICAL THERAPY PC

Practice address

3930 Richmond Ave Ste 200
Staten Island, NY 10312-5103

Phone

(718) 317-9801

NPI assigned

Feb 21, 2022

Organization subpart

No

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

Authorized official

Name

Samuel Yoo, PT

Title

PT

Phone

(646) 240-8453

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1124773940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125103",
            "telephone_number": "718-317-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL YOO PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "646-240-8453",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MEMBER PTAN FOR QUEENS",
            "identifier": "G400061606",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MEMBER PTAN FOR BROOKLYN, STATEN ISLAND, MANHATTAN",
            "identifier": "A400026932",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891939625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Samper, PTA
• Samritan Daytop Village
• Kristine Samson, MD
• Divya Diana Samtani Khiatani
• Shelu Samu
• Breindy Samuel, MS SPECIAL EDUCATION
• Jesin Samuel
• Jonathan Hendrickson Samuel, PA-C
• Nathaniel Samuel
• Quincer Zahra Samuel, M.D.

• Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.