Individual provider Active NPI

David Kun Ho Jung, DPT

  • Physical Therapist
  • Long Island City, NY
National Provider Identifier
1306363312
Registry record updated Nov 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042140-1 Issued in NY
Practice address
2420 Jackson Ave Ste 205
Long Island City, NY 11101-4332
Phone
(347) 561-8002
NPI assigned
Aug 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2022

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 042140-1 NY Primary

Addresses

Primary practice location

2420 Jackson Ave Ste 205
Long Island City, NY 11101-4332

Mailing address

543 48TH Ave Apt 5E
Long Island City, NY 11101-5931
Phone (213) 393-0099

Other practice location 1

51 Nassau Ave Ste 1C
Brooklyn, NY 11222-3170
Phone (347) 561-8002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042140-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kellen Ryan Scantlebury Physical Therapy PLLC Physical Therapist CurrentSince Jan 16, 2025 Accepting new patients
Lion Physical Therapy PLLC CurrentSince Nov 27, 2022 Accepting new patients

Locations

51 Nassau Ave
Ste 1C
Brooklyn, NY 11222
Phone (347) 561-8002

2420 Jackson Ave
Ste 205
Long Island City, NY 11101
Phone (347) 561-8002

153 W 27th St
Ste 1204
New York, NY 10001
Phone (646) 875-8348

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669248000000",
    "number": "1306363312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 48TH AVE APT 5E",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111015931",
            "telephone_number": "213-393-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 JACKSON AVE STE 205",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014332",
            "telephone_number": "347-561-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Nassau Ave Ste 1C",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112223170",
            "country_code": "US",
            "telephone_number": "347-561-8002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "DAVID",
        "middle_name": "KUN HO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-11-24",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042140-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2022; 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.