Individual provider Active NPI

Jason Szepok Kong, D.O

  • Physical Medicine & Rehabilitation Physician
  • Flushing, NY
National Provider Identifier
1609069715
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
246399 Issued in NY
Practice address
3901 Main St
Suite 309
Flushing, NY 11354-5432
Phone
(718) 886-2906
Fax
(718) 301-1775
NPI assigned
Aug 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 246399 NY Primary

Addresses

Primary practice location

3901 Main St
Suite 309
Flushing, NY 11354-5432

Mailing address

3901 Main St
Suite 309
Flushing, NY 11354-5432
Phone (718) 886-2906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080806000193 NY Practitioner - Physical Medicine and RehabilitationPractitioner - General PracticePractitioner - Osteopathic Manipulative Medicine 0840364006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: General Practice, Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3901 Main St
Suite 309
Flushing, NY 11354-5434
Phone (718) 886-2906

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hanwol Physical Therapy P.C. CurrentSince Jul 23, 2018 Accepting new patients
Jason Szepok Kong DO PC CurrentSince Aug 1, 2008 Accepting new patients
Integrative Medical Care PC Past Accepting new patients

Locations

3901 Main St
Ste 309
Flushing, NY 11354
Phone (718) 886-2906

557 Main St
#2
New Rochelle, NY 10801
Phone (203) 856-8550

6308 Roosevelt Ave
Woodside, NY 11377
Phone (224) 423-8053

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 3

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": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1609069715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST",
            "address_2": "SUITE 309",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545432",
            "telephone_number": "718-886-2906",
            "fax_number": "718-301-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST",
            "address_2": "SUITE 309",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545432",
            "telephone_number": "718-886-2906",
            "fax_number": "718-301-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "JASON",
        "middle_name": "SZEPOK",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-22",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "246399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.