Individual provider Active NPI

Justin Dong

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1568166387
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
13625 Maple Ave Ste 201
Flushing, NY 11355-3891
Phone
(718) 886-8562
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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 Primary

Addresses

Primary practice location

13625 Maple Ave Ste 201
Flushing, NY 11355-3891

Mailing address

15446 26TH Ave
Flushing, NY 11354-1518
Phone (917) 885-3996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515001405 NY Practitioner - Physical Therapist in Private Practice 4880050038 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT and OT for Senior Rehab at Home PLLC Physical Therapist CurrentSince May 1, 2025 Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

Organizations & group practices 1

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1568166387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15446 26TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541518",
            "telephone_number": "917-885-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 MAPLE AVE STE 201",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553891",
            "telephone_number": "718-886-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONG",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.