J Lee Physical Therapy P.C

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

J LEE PHYSICAL THERAPY P.C

Practice address

16410 Northern Blvd Ste 201
Flushing, NY 11358-2668

Phone

(718) 463-6700

Fax

(718) 463-6174

NPI assigned

Aug 24, 2020

Last updated

Feb 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaekwan LeeNPI 1417512203

Title

President

Phone

(718) 463-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaekwan Lee

  • Physical Therapist
  • Flushing, NY
  • NPI 1417512203
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1528671146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16410 NORTHERN BLVD STE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582668",
            "telephone_number": "718-463-6700",
            "fax_number": "718-463-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 NORTHERN BLVD STE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113582668",
            "telephone_number": "718-463-6700",
            "fax_number": "718-463-6174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 162nd St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113583279",
            "country_code": "US",
            "telephone_number": "929-362-7708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16213 46th Ave Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113583698",
            "country_code": "US",
            "telephone_number": "929-362-7708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Madison Ave Fl 6",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100176306",
            "country_code": "US",
            "telephone_number": "347-321-2827",
            "fax_number": "929-445-2827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J LEE PHYSICAL THERAPY P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAEKWAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-463-6700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1528671146",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Flushing, NY
• Providers in Flushing, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.