Individual provider Active NPI

Tae Jin Chung

  • Physical Therapist
  • Garden City, NY
National Provider Identifier
1184559759
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
055909 Issued in NY
Practice address
910 Franklin Ave
Garden City, NY 11530-2940
Phone
(516) 330-7176
NPI assigned
Jun 16, 2026
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 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 055909 NY Primary

Addresses

Primary practice location

910 Franklin Ave
Garden City, NY 11530-2940

Mailing address

6457 231St St
Oakland Gardens, NY 11364-2715
Phone (516) 330-7176

Other names 1

  • Tae Chung Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Luna Care Physical Therapy PLLCGroup PAC ID 0840604666, 62 clinicians
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians

Practice addresses (Care Compare)

Pearl River, NY 10965
Phone (866) 525-3175

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1781568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1184559759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6457 231ST ST",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113642715",
            "telephone_number": "516-330-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 FRANKLIN AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302940",
            "telephone_number": "516-330-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TAE JIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-16",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "055909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAE",
            "last_name": "CHUNG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.