Ji Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

JI PHYSICAL THERAPY PC

Practice address

6308 Roosevelt Ave
Woodside, NY 11377-3642

Phone

(347) 209-3684

NPI assigned

Mar 16, 2022

Organization subpart

No

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

Authorized official

Name

Bonghak JiNPI 1144887597

Title

PT

Phone

(347) 209-3684

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Bonghak Ji, PT. DPT. OCS. CSCS.

  • Orthopedic Physical Therapist
  • Flushing, NY
  • NPI 1144887597
  Medicare reassignment Authorized official
• Jack Herskovits, PSYD

  • Psychologist
  • New York, NY
  • NPI 1861697872
  NPD (past)

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1124776307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14021 32ND AVE APT 6CN",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542640",
            "telephone_number": "347-209-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773642",
            "telephone_number": "347-209-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JI PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "JI",
        "authorized_official_first_name": "BONGHAK",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "347-209-3684"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Dianne Jean-Gilles
• Josue Jean-Gilles, OTR/L
• Fednor Jean-Louis, COTA
• Jeffrey Carrasquillo DMD PLLC
• Ji Dental Care PLLC
• Alfy Jimenez Sr., LCSW
• Jinghuan Cai Acupuncture P C
• JMD Pharmacy Inc
• Chenelle Jones, AGPCNP-BC
• Dahna Jones

• Physical Therapist in Woodside, NY
• Providers in Woodside, 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 Sep 27, 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.