Individual provider Active NPI

Soojung Jung

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1518583103
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
044366 Issued in NY
Practice address
837 59TH St FL 5
Brooklyn, NY 11220-5577
Phone
(646) 532-7746
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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 044366 NY Primary

Addresses

Primary practice location

837 59TH St FL 5
Brooklyn, NY 11220-5577

Mailing address

4502 Ditmars Blvd Apt 218
Astoria, NY 11105-1348
Phone (646) 532-7746

Other practice location 1

4502 Ditmars Blvd Apt 218
Astoria, NY 11105-1348
Phone (646) 532-7746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729001341 NY Practitioner - Physical Therapist in Private Practice 2062837719 Reassigns benefits to 3 organizations
Practice locations: Flushing, NY

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.87 of 100Reported as group
Quality
88.31
Improvement activities
40
Cost
69.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moon Rehab PT PC Physical Therapist CurrentSince Nov 8, 2021 Accepting new patients
New York Luna Care Physical Therapy PLLC Physical Therapist CurrentSince Aug 25, 2023 Accepting new patients
Jung Physical Therapy PC Physical Therapist CurrentSince Jun 9, 2022 Accepting new patients

Locations

871 59th St
Fl 1
Brooklyn, NY 11220
Phone (201) 940-0837

3719 108th St
Corona, NY 11368
Phone (516) 388-0797

7402 Grand Ave
Ste 3B
Elmhurst, NY 11373
Phone (917) 369-1017

13620 Maple Ave
Ste C302
Flushing, NY 11355

13511 40th Rd
Ste 3A
Flushing, NY 11354
Phone (646) 417-0641

1 Blue Hill Plz
Ste 1509
Pearl River, NY 10965
Phone (201) 914-0063

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": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1518583103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 DITMARS BLVD APT 218",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051348",
            "telephone_number": "646-532-7746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 59TH ST FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112205577",
            "telephone_number": "646-532-7746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Ditmars Blvd Apt 218",
            "address_purpose": "LOCATION",
            "city": "Astoria",
            "state": "NY",
            "postal_code": "111051348",
            "country_code": "US",
            "telephone_number": "646-532-7746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNG",
        "first_name": "SOOJUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.