Eunmi Im

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

012384 Issued in NY

Practice address

21915A Northern Blvd
Flushing, NY 11361-3525

Phone

(718) 423-3400

NPI assigned

Nov 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• 8TH Ave Physical Therapy PC

  • Physical Therapist
  • Bayside, NY
  • NPI 1588967475
  NPD (past)
• Bayside USA Acupuncture P.C.

  • Acupuncturist
  • Bayside, NY
  • NPI 1134078595
  NPD (past)

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1215470760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 163RD ST FL 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21915A NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113613525",
            "telephone_number": "718-423-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "EUNMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Ilyaich
• Diana Ilyasova
• Marianna Ilyasova, OTRL
• Mary Alexandra Ilyasova
• Benyamin Ilyayev, DDS
• Jin Myung Im, ACUPUNCTURIST
• Shinyoung Im
• In Depth Psychotherapy LCSW PC
• Eligio Leandro Infante
• Infinite Kindness Physical Therapy, P.C

• Physical Therapy Assistant in Flushing, NY
• Providers in Flushing, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.