Organization Active NPI

Ny West Acupuncture and Physical Therapy PLLC

  • Physical Therapist
  • New York, NY
National Provider Identifier
1558062760
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NY WEST ACUPUNCTURE AND PHYSICAL THERAPY PLLC
Practice address
613 W 169TH St Apt 4
New York, NY 10032-2914
Phone
(848) 565-4819
NPI assigned
Mar 14, 2023
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Authorized official

Name
Jenny Dong
Title
Office Manager
Phone
(848) 565-4819

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X NU
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

613 W 169TH St Apt 4
New York, NY 10032-2914

Mailing address

613 W 169TH St Apt 4
New York, NY 10032-2914
Phone (848) 565-4819

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241031000288 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678006582 Receives reassigned benefits from 1 practitioner
Practice locations: Bayside, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1558062760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 W 169TH ST APT 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322914",
            "telephone_number": "848-565-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W 169TH ST APT 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100322914",
            "telephone_number": "848-565-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY WEST ACUPUNCTURE AND PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "DONG",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "848-565-4819"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "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 Mar 16, 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.