Individual provider Active NPI

Youngki Kong

  • Physical Therapist
  • Woodside, NY
National Provider Identifier
1134768005
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40053 Issued in NY
Practice address
4322 50TH St Ste 1B
Woodside, NY 11377-4442
Phone
(718) 424-4455
NPI assigned
Dec 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 40053 NY Primary

Addresses

Primary practice location

4322 50TH St Ste 1B
Woodside, NY 11377-4442

Mailing address

4304 158TH St
Apt 2E
Flushing, NY 11358-3166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504000568 NY Practitioner - Physical Therapist in Private Practice 3375951619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40053NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Jan 13, 2023 Accepting new patients

Locations

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

Organizations & group practices 2

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": "1577145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1134768005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 158TH ST",
            "address_2": "APT 2E",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4322 50TH ST STE 1B",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774442",
            "telephone_number": "718-424-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "YOUNGKI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "40053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.