Individual provider Active NPI

Soyeon Jo, PT

  • Physical Therapist
  • East Meadow, NY
National Provider Identifier
1154739043
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032694 Issued in NY
Practice address
801 Merrick Avenue
East Meadow, NY 11554
Phone
(516) 393-8872
NPI assigned
Jul 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 032694 NY Primary

Addresses

Primary practice location

801 Merrick Avenue
East Meadow, NY 11554

Mailing address

145 Community Drive
Port Washington, NY 11050-2056
Phone (718) 290-3014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141016000432 NY Practitioner - Physical Therapist in Private Practice 0446471452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Boston University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Community Dr
Great Neck, NY 11021-5502
Phone (516) 719-3745

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

9525 Queens Blvd
Suite 3D
Rego Park, NY 11374-4510
Phone (718) 925-6212

Merit-based Incentive Payment System (MIPS)

Final score
77.16 of 100Reported as group
Quality
70
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1154739043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COMMUNITY DRIVE",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502056",
            "telephone_number": "718-290-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MERRICK AVENUE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "11554",
            "telephone_number": "516-393-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "SOYEON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.