Organization Active NPI

Legend Rehabilitation-Acupuncture & Physical Therapy PC

  • Physical Disabilities Residential Treatment Facility
  • Staten Island, NY
National Provider Identifier
1588949747
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
14071 Issued in NY
Legal business name
LEGEND REHABILITATION-ACUPUNCTURE & PHYSICAL THERAPY PC
Practice address
1481 Richmond Rd
Staten Island, NY 10304-2309
Phone
(718) 980-9888
Fax
(718) 980-1403
NPI assigned
Oct 19, 2011
Last updated
Oct 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Mr. Lap C Ku, PT L.ACNPI 1508909748
Title
Director
Phone
(718) 980-9888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 14071 NY Primary
Physical Disabilities Residential Treatment Facility 320700000X 001272-1 NY

Addresses

Primary practice location

1481 Richmond Rd
Staten Island, NY 10304-2309

Mailing address

1481 Richmond Rd
Staten Island, NY 10304-2309
Phone (718) 980-9888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130204000079 NY Part B Supplier - Clinic/Group Practice 7214181049 Receives reassigned benefits from 1 practitioner
Practice locations: Staten Island, NY

National Provider Directory

National Provider Directory

Locations

1481 Richmond Rd
Staten Island, NY 10304
Phone (718) 980-9888

Practitioners & affiliated clinicians

Practitioners 2

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": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1588949747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042309",
            "telephone_number": "718-980-9888",
            "fax_number": "718-980-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042309",
            "telephone_number": "718-980-9888",
            "fax_number": "718-980-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND REHABILITATION-ACUPUNCTURE & PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "KU",
        "authorized_official_first_name": "LAP",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-980-9888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT   L.AC"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "14071",
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "001272-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.