Individual provider Active NPI

Taeun Ha

  • Physical Therapist
  • New York, NY
National Provider Identifier
1124845441
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02294900 Issued in NJ
Practice address
225 Broadway Ste 1630B
New York, NY 10007-3001
Phone
(551) 359-4472
NPI assigned
Sep 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA02294900 NJ Primary

Addresses

Primary practice location

225 Broadway Ste 1630B
New York, NY 10007-3001

Mailing address

225 Broadway Ste 1630B
New York, NY 10007-3001
Phone (551) 359-4472

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031000859 NJ Practitioner - Physical Therapist in Private Practice 4385177203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

266 Harristown Rd
Suite 304
Glen Rock, NJ 07452-3361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02294900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince Nov 17, 2025 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Syc Physical Therapy P.C Physical Therapist PastSince May 18, 2025 Accepting new patients

Locations

515 Brick Blvd
Brick, NJ 08723
Phone (732) 800-6015

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

250 River St
Hackensack, NJ 07601
Phone (201) 820-3730

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

39 E Front St
Red Bank, NJ 07701
Phone (732) 978-1500

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 5

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": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1124845441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BROADWAY STE 1630B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "551-359-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADWAY STE 1630B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "551-359-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "TAEUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02294900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.