Organization Active NPI

Mint Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Melville, NY
National Provider Identifier
1558174946
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MINT PHYSICAL THERAPY, P.C.
Practice address
510 Broadhollow Rd Ste 200
Melville, NY 11747-3606
Phone
(516) 460-0650
Fax
(516) 309-4801
NPI assigned
Jan 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Kimberely Hyunae Lee
Title
President
Phone
(516) 460-0650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

510 Broadhollow Rd Ste 200
Melville, NY 11747-3606

Mailing address

14 Redwood Dr
Plainview, NY 11803-5215
Phone (516) 460-0650

National Provider Directory

National Provider Directory

Locations

510 Broadhollow Rd
Ste 200
Melville, NY 11747
Phone (516) 460-0650

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1558174946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 REDWOOD DR",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118035215",
            "telephone_number": "516-460-0650",
            "fax_number": "516-309-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BROADHOLLOW RD STE 200",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473606",
            "telephone_number": "516-460-0650",
            "fax_number": "516-309-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KIMBERELY",
        "authorized_official_middle_name": "HYUNAE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-460-0650"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.