Individual provider Active NPI

Sung Bam Wee, PT

  • Physical Therapist
  • Fort Lee, NJ
National Provider Identifier
1467552182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01192500 Issued in NJ
Practice address
1055 Palisade Ave
1St Floor
Fort Lee, NJ 07024-6329
Phone
(201) 886-1200
Fax
(201) 886-0119
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA01192500 NJ Primary

Addresses

Primary practice location

1055 Palisade Ave
1St Floor
Fort Lee, NJ 07024-6329

Mailing address

1055 Palisade Ave
1St Floor
Fort Lee, NJ 07024-6329
Phone (201) 886-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070226000626 NJ Practitioner - Physical Therapist in Private Practice 3779685508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

190 Sylvan
Suite 1
Englewood Cliffs, NJ 07632

190 Sylvan Ave
Suite 1
Englewood Cliffs, NJ 07632-2542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01192500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wees Physical Therapy and Wellness Clinic Physical Therapist CurrentSince Sep 6, 2006 Accepting new patients
Top Choice Medical LLC Physical Therapist Past Accepting new patients
Ying Shim, MD PA Past Accepting new patients

Locations

190 Sylvan Ave
Ste 1
Englewood Cliffs, NJ 07632
Phone (201) 886-1200

1055 Palisade Ave
#1
Fort Lee, NJ 07024
Phone (201) 886-1200

Organizations & group practices 3

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467552182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 PALISADE AVE",
            "address_2": "1ST FLOOR",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246329",
            "telephone_number": "201-886-1200",
            "fax_number": "201-886-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 PALISADE AVE",
            "address_2": "1ST FLOOR",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246329",
            "telephone_number": "201-886-1200",
            "fax_number": "201-886-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEE",
        "first_name": "SUNG BAM",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01192500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.