Individual provider Active NPI

Yu-Jen Hwang, D.P.T.

  • Physical Therapist
  • Ridgewood, NY
National Provider Identifier
1235639667
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
041671-1 Issued in NY
Practice address
55-05 Myrtle Avenue
2ND Floor
Ridgewood, NY 11385
Phone
(646) 535-2983
NPI assigned
Feb 12, 2018
Reactivated
Mar 25, 2019
Last updated
Mar 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 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 041671-1 NY Primary

Addresses

Primary practice location

55-05 Myrtle Avenue
2ND Floor
Ridgewood, NY 11385

Mailing address

281 Broadway
2ND Floor
New York, NY 10007-1831
Phone (646) 596-7386

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415001917 OR Practitioner - Physical Therapist in Private Practice 4183987324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stratos Group LLCGroup PAC ID 6709155534, 10 clinicians

Practice addresses (Care Compare)

18215 NW W Union Rd
Suite B
Portland, OR 97229-2139
Phone (971) 213-3335

20510 SW Roy Rogers Rd
Suite 120
Sherwood, OR 97140-9320
Phone (971) 213-3335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041671-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stratos Group LLC Physical Therapist CurrentSince Sep 13, 2021 Accepting new patients
Active Edge Physical Therapy & Sports Medicine P.C. CurrentSince Mar 1, 2021 Accepting new patients

Locations

18215 NW West Union Rd
Ste B
Portland, OR 97229
Phone (971) 213-3335

20510 SW Roy Rogers Rd
Ste 120
Sherwood, OR 97140
Phone (971) 213-3335

2020 8th Ave
Ste D
West Linn, OR 97068
Phone (503) 387-5449

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": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1235639667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 BROADWAY",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071831",
            "telephone_number": "646-596-7386",
            "fax_number": "844-408-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55-05 MYRTLE AVENUE",
            "address_2": "2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "646-535-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HWANG",
        "first_name": "YU-JEN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2019-03-25",
        "deactivation_date": "2018-09-20",
        "reactivation_date": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041671-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.