Active NPI
Hyungtae Kim
- Physical Therapist
- Elmont, NY
National Provider Identifier
1467754168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 027901
- Practice address
- 115 Meacham Ave
Elmont, NY 11003-2664 - Phone
- (854) 433-4335
- Fax
- (585) 443-3434
- NPI assigned
- Dec 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 027901 | NY | Primary |
Addresses
Primary practice location
115 Meacham Ave
Elmont, NY 11003-2664
Mailing address
115 Meacham Ave
Elmont, NY 11003-2664
Phone (854) 433-4335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027901 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1467754168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MEACHAM AVE",
"city": "ELMONT",
"state": "NY",
"postal_code": "110032664",
"telephone_number": "854-433-4335",
"fax_number": "585-443-3434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MEACHAM AVE",
"city": "ELMONT",
"state": "NY",
"postal_code": "110032664",
"telephone_number": "854-433-4335",
"fax_number": "585-443-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HYUNGTAE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-12-01",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "027901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.