Organization Active NPI

New Core Physical Therapy PC

  • Physical Therapist
  • Douglaston, NY
National Provider Identifier
1205473774
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NEW CORE PHYSICAL THERAPY PC
Practice address
4029 235TH St FL 2
Douglaston, NY 11363-1509
Phone
(718) 359-1004
Fax
(718) 281-4402
NPI assigned
Dec 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Wooyoung BaeNPI 1194369595
Title
President
Phone
(718) 281-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4029 235TH St FL 2
Douglaston, NY 11363-1509

Mailing address

4029 235TH St FL 2
Douglaston, NY 11363-1509
Phone (718) 359-1004

Other practice location 1

15644 Northern Blvd Ste D
Flushing, NY 11354-5066
Phone (718) 359-1004

Other practice location 2

25512 Northern Blvd
Little Neck, NY 11362-1470
Phone (718) 281-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200904000357 NY Part B Supplier - Clinic/Group Practice 1456778489 Receives reassigned benefits from 1 practitioner
Practice locations: Douglaston, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

4029 235th St
Fl 3
Douglaston, NY 11363

4029 235th St
#3
Little Neck, NY 11363
Phone (718) 359-1004

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1205473774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631509",
            "telephone_number": "718-359-1004",
            "fax_number": "718-281-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631509",
            "telephone_number": "718-359-1004",
            "fax_number": "718-281-4402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15644 Northern Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545066",
            "country_code": "US",
            "telephone_number": "718-359-1004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25512 Northern Blvd",
            "address_purpose": "LOCATION",
            "city": "Little Neck",
            "state": "NY",
            "postal_code": "113621470",
            "country_code": "US",
            "telephone_number": "718-281-4400",
            "fax_number": "718-281-4402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW CORE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "WOOYOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-281-4400"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglaston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.