Individual provider Active NPI

Kyla Tan

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1346940699
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050085 Issued in NY
Practice address
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Phone
(516) 829-0030
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 050085 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 11
Great Neck, NY 11021-4802

Mailing address

8310 35TH Ave Apt 4R
Jackson Heights, NY 11372

Other practice location 1

8310 35th Ave Apt 4R
Jackson Heights, NY 11372
Phone (347) 622-5439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818000422 NY Practitioner - Physical Therapist in Private Practice 7618339904 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Sutton Place Physical Therapy PCGroup PAC ID 8921999046, 13 clinicians
Handd Dynamic Physical and Occupational Therapy, PLLCGroup PAC ID 7416132634, 45 clinicians

Practice addresses (Care Compare)

211 W 71St St
New York, NY 10023-3766
Phone (212) 499-0876

333 E 56TH St
New York, NY 10022-3758
Phone (212) 317-1600

62 E 88TH St
Lowr Level
New York, NY 10128-1151
Phone (212) 988-2501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reddy Care Physical Therapy PC Physical Therapist CurrentSince Oct 16, 2023 Accepting new patients
H&D Physical Therapy & Occupational Therapy PLLC Physical Therapist CurrentSince Apr 13, 2026 Accepting new patients
H&D Dynamic Physical & Occupational Therapy, PLLC Physical Therapist CurrentSince Apr 13, 2026 Accepting new patients
High Line Rehab PT PC Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Sutton Place Physical Therapy PC Physical Therapist CurrentSince Jun 3, 2024 Accepting new patients

Locations

309 Northwest Dr
Farmingdale, NY 11735
Phone (516) 420-2900

27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030

475 Northern Blvd
Ste 27
Great Neck, NY 11021

475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023

62 E 88th St
Lowr
New York, NY 10128
Phone (212) 369-9200

333 E 56th St
Ofc 1
New York, NY 10022
Phone (212) 289-3236

62 E 88th St
New York, NY 10128
Phone (212) 427-7000

333 E 56th St
New York, NY 10022
Phone (212) 308-2540

211 W 71st St
New York, NY 10023
Phone (212) 721-6200

Organizations & group practices 5

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1346940699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 35TH AVE APT 4R",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 11",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8310 35th Ave Apt 4R",
            "address_purpose": "LOCATION",
            "city": "Jackson Heights",
            "state": "NY",
            "postal_code": "11372",
            "country_code": "US",
            "telephone_number": "347-622-5439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "KYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050085",
            "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 Oct 17, 2023; 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.