Individual provider Active NPI

Sam Wang, D.P.T.

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1174097737
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042966 Issued in NY
Practice address
335 Court Street
Brooklyn, NY 11231
Phone
(718) 855-1543
NPI assigned
Jan 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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 042966 NY Primary

Addresses

Primary practice location

335 Court Street
Brooklyn, NY 11231

Mailing address

765 48TH Street
Brooklyn, NY 11220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220511002047 NY Practitioner - Physical Therapist in Private Practice 6901283043 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince May 4, 2022 Accepting new patients
Maimonides Bone and Joint Faculty Practice Physical Therapy CurrentSince Sep 12, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Maimonides Faculty Practice Plan CurrentSince Sep 15, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 4, 2022 Accepting new patients
Sam Wang Physical Therapy PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 4, 2022 Accepting new patients
RPT Physical Therapy, P.C. Physical Therapist PastSince Aug 13, 2013 Accepting new patients
Maimonides Medical Center Orthopaedic FPP Past Accepting new patients

Locations

6010 Bay Pkwy
Brooklyn, NY 11204
Phone (718) 238-2100

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

121 Broadhollow Rd
Melville, NY 11747
Phone (631) 354-5600

576 Broadhollow Rd
Melville, NY 11747

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

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 9

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": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1174097737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 48TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 COURT STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11231",
            "telephone_number": "718-855-1543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SAM",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.