Individual provider Active NPI

Aiden Yoon, PT, DPT

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1215579065
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01874900 Issued in NJ
Practice address
925 Clifton Ave Ste 102
Clifton, NJ 07013-2724
Phone
(973) 330-0705
Fax
(973) 330-0706
NPI assigned
Oct 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 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 40QA01874900 NJ Primary

Addresses

Primary practice location

925 Clifton Ave Ste 102
Clifton, NJ 07013-2724

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Other practice location 1

1011 Clifton Ave
Clifton, NJ 07013-3518
Phone (973) 778-1134

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112001327 NJ Practitioner - Physical Therapist in Private Practice 1355773490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

925 Clifton Ave
Suite 102
Clifton, NJ 07013-2724
Phone (973) 330-0705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01874900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Oct 16, 2019 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Oct 16, 2019 Accepting new patients

Locations

1011 Clifton Ave
Clifton, NJ 07013
Phone (973) 471-8200

925 Clifton Ave
Ste 102
Clifton, NJ 07013
Phone (973) 330-0705

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

1057 Commerce Ave
Union, NJ 07083
Phone (866) 467-1770

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 3

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": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571011200000",
    "number": "1215579065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-584-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CLIFTON AVE STE 102",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132724",
            "telephone_number": "973-330-0705",
            "fax_number": "973-330-0706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Clifton Ave",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070133518",
            "country_code": "US",
            "telephone_number": "973-778-1134",
            "fax_number": "973-614-1530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOON",
        "first_name": "AIDEN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01874900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.