Individual provider Active NPI

Hyeongjin Jeon, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1508346065
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039989 Issued in NY
Practice address
22 E 49TH St FL 6
New York, NY 10017-1018
Phone
(332) 895-5677
Fax
(332) 895-5290
NPI assigned
Aug 15, 2018
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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 039989 NY Primary

Addresses

Primary practice location

22 E 49TH St FL 6
New York, NY 10017-1018

Mailing address

22 E 49TH St FL 6
New York, NY 10017-1018
Phone (332) 895-5677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211208000092 NY Practitioner - Physical Therapist in Private Practice 8820488364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13656 39TH Ave
Suite 305
Flushing, NY 11354-5508
Phone (718) 902-3329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039989NYMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hyeongjin Jeon PT PC Physical Therapist CurrentSince Aug 16, 2019 Accepting new patients

Locations

20935 Northern Blvd
Ste 215
Bayside, NY 11361
Phone (718) 225-9000

13656 39th Ave
Ste 305
Flushing, NY 11354
Phone (718) 902-3329

15408 Northern Blvd
Ste 2F
Flushing, NY 11354
Phone (718) 939-1275

22 E 49th St
Fl 6
New York, NY 10017
Phone (212) 753-1175

3930 Richmond Ave
Ste 200
Staten Island, NY 10312
Phone (646) 483-6564

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1508346065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 E 49TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171018",
            "telephone_number": "332-895-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 E 49TH ST FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100171018",
            "telephone_number": "332-895-5677",
            "fax_number": "332-895-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEON",
        "first_name": "HYEONGJIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.