Everbright Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040048 Issued in NY

Legal business name

EVERBRIGHT PHYSICAL THERAPY PLLC

Practice address

10714 71St Rd FL 1
Forest Hills, NY 11375-4719

Phone

(718) 755-2999

Fax

(347) 710-8806

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Shuqiang QiNPI 1700230729

Title

DPT/Owner

Phone

(917) 563-8610

Specialties & licenses 1

Addresses

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.

• Shuqiang Qi

  • Physical Therapist
  • Forest Hills, NY
  • NPI 1700230729
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1548775356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 AUSTIN STREET",
            "address_2": "MB#194",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755354",
            "telephone_number": "917-563-8610",
            "fax_number": "347-710-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10714 71ST RD FL 1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754719",
            "telephone_number": "718-755-2999",
            "fax_number": "347-710-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERBRIGHT PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "QI",
        "authorized_official_first_name": "SHUQIANG",
        "authorized_official_title_or_position": "DPT/OWNER",
        "authorized_official_telephone_number": "917-563-8610"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Forest Hills, NY
• Providers in Forest Hills, 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 Jul 6, 2020; 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.