Individual provider Active NPI

Jieke Ke

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1326417866
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62 P99373 Issued in NY
Practice address
770 Middle Neck Rd
Great Neck, NY 11024-1956
Phone
(516) 307-8067
NPI assigned
Sep 15, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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 62 P99373 NY Primary

Addresses

Primary practice location

770 Middle Neck Rd
Great Neck, NY 11024-1956

Mailing address

770 Middle Neck Rd
Great Neck, NY 11024-1956
Phone (516) 307-8067

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215002363 NY Practitioner - Physical Therapist in Private Practice 3779866850 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kenetic Physical Therapy PCGroup PAC ID 0749611903, 2 clinicians

Practice addresses (Care Compare)

489 Great Neck Rd
Great Neck, NY 11021-4306
Phone (646) 420-8374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62 P99373NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kenetic Physical Therapy PC Physical Therapist CurrentSince Mar 7, 2020 Accepting new patients
Health Solutions Physical Therapy, PC Physical Therapist CurrentSince Jan 9, 2017 Accepting new patients

Locations

489 Great Neck Rd
Great Neck, NY 11021
Phone (646) 420-8374

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1326417866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241956",
            "telephone_number": "516-307-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110241956",
            "telephone_number": "516-307-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KE",
        "first_name": "JIEKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62 P99373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.