Active NPI
Kwangsu Lee, RPT
- Physical Therapist
- Bayside, NY
National Provider Identifier
1609281120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 031558
- Practice address
- 21915A Northern Blvd
Bayside, NY 11361-3525 - Phone
- (718) 423-3400
- NPI assigned
- Jun 23, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 031558 | NY | Primary |
Addresses
Primary practice location
21915A Northern Blvd
Bayside, NY 11361-3525
Mailing address
21915A Northern Blvd
Bayside, NY 11361-3525
Phone (718) 423-3400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031558 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayside USA Acupuncture P.C. | Past | Accepting new patients |
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.
-
- Acupuncturist
- Bayside, NY
- NPI 1134078595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1609281120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21915A NORTHERN BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613525",
"telephone_number": "718-423-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21915A NORTHERN BLVD",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613525",
"telephone_number": "718-423-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "KWANGSU",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-23",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "031558",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "031558",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.