Individual provider Active NPI

Sami Seo, DPT

  • Physical Therapist
  • Douglaston, NY
National Provider Identifier
1366215287
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037444 Issued in NY
Practice address
4029 235TH St FL 2
Douglaston, NY 11363-1509
Phone
(718) 359-1004
Fax
(718) 691-4053
NPI assigned
Nov 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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 037444 NY Primary

Addresses

Primary practice location

4029 235TH St FL 2
Douglaston, NY 11363-1509

Mailing address

4029 235TH St FL 2
Douglaston, NY 11363-1599
Phone (718) 359-1004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231228003326 NY Practitioner - Physical Therapist in Private Practice 4880044171 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
037444NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Corpus Physical Therapy PC Physical Therapist CurrentSince Sep 13, 2024 Accepting new patients

Locations

4029 235th St
#3
Little Neck, NY 11363
Phone (718) 359-1004

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": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1366215287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631599",
            "telephone_number": "718-359-1004",
            "fax_number": "718-691-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 235TH ST FL 2",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631509",
            "telephone_number": "718-359-1004",
            "fax_number": "718-691-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "SAMI",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglaston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.