Individual provider Active NPI

Yujin Gang, RPT

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1609309392
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
041310 Issued in NY
Practice address
21915A Northern Blvd
Bayside, NY 11361-3525
Phone
(718) 423-3400
Fax
(908) 888-0248
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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 041310 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

IdentifierTypeStateIssuer
041310OtherNYLICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041310NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
8TH Ave Physical Therapy PC Physical Therapist Past Accepting new patients
Bayside USA Acupuncture P.C. Past Accepting new patients

Organizations & group practices 2

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1609309392",
    "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",
            "fax_number": "908-888-0248"
        },
        {
            "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",
            "fax_number": "908-888-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANG",
        "first_name": "YUJIN",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "041310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "041310",
            "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 Apr 10, 2017; 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.