Organization Active NPI

Youngs Physical Therapy P C

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1295992014
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16067 Issued in NY
Legal business name
YOUNGS PHYSICAL THERAPY P C
Practice address
1417 Bell Blvd
Bayside, NY 11360-1211
Phone
(718) 352-8010
Fax
(718) 352-8012
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Authorized official

Name
Youngsoo Oh, P.T., L.ACNPI 1528187507
Title
Owner
Phone
(718) 352-8010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X 03477 NY
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 16067 NY Primary

Addresses

Primary practice location

1417 Bell Blvd
Bayside, NY 11360-1211

Mailing address

1417 Bell Blvd
Bayside, NY 11360-1211
Phone (718) 352-8010

Other identifiers 1

IdentifierTypeStateIssuer
02762316MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080522000591 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1456420967 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1410 Broadway
Ste 202
New York, NY 10018
Phone (212) 354-2225

Practitioners & affiliated clinicians

Practitioners 4

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": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1295992014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601211",
            "telephone_number": "718-352-8010",
            "fax_number": "718-352-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601211",
            "telephone_number": "718-352-8010",
            "fax_number": "718-352-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGS PHYSICAL THERAPY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "OH",
        "authorized_official_first_name": "YOUNGSOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-352-8010",
        "authorized_official_credential": "P.T., L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "03477",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "16067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02762316",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.