Organization Active NPI

Richon Integrated Health Services-PT&Acupuncture,PLLC.

  • Physical Therapy Clinic/Center
  • Bayside, NY
National Provider Identifier
1417280124
Registry record updated Sep 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
018320 Issued in NY
Legal business name
RICHON INTEGRATED HEALTH SERVICES-PT&ACUPUNCTURE,PLLC.
Practice address
2415 Bell Blvd
Bayside, NY 11360-2222
Phone
(718) 357-3638
Fax
(718) 357-3638
NPI assigned
Sep 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2009

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

Authorized official

Name
Jing Shan, M.S.NPI 1598732620
Title
Physical Therapist
Phone
(718) 357-3638

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 018320 NY Primary

Addresses

Primary practice location

2415 Bell Blvd
Bayside, NY 11360-2222

Mailing address

2415 Bell Blvd
Bayside, NY 11360-2222
Phone (718) 357-3638

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091014000201 NY Part B Supplier - Clinic/Group Practice 7113063678 Receives reassigned benefits from 1 practitioner
Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1252800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252800000000",
    "number": "1417280124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602222",
            "telephone_number": "718-357-3638",
            "fax_number": "718-357-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602222",
            "telephone_number": "718-357-3638",
            "fax_number": "718-357-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHON INTEGRATED HEALTH SERVICES-PT&ACUPUNCTURE,PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-13",
        "last_updated": "2009-09-13",
        "status": "A",
        "authorized_official_last_name": "SHAN",
        "authorized_official_first_name": "JING",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "718-357-3638",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "018320",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 13, 2009; 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.