Individual provider Active NPI

Juwan Hong, P.T.

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1629105754
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018178 Issued in NY
Practice address
15408 Northern Blvd
2F
Flushing, NY 11354-5040
Phone
(718) 939-1275
Fax
(718) 939-1277
NPI assigned
Feb 27, 2007
Last updated
Apr 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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 018178 NY Primary

Addresses

Primary practice location

15408 Northern Blvd
2F
Flushing, NY 11354-5040

Mailing address

15408 Northern Blvd
2F
Flushing, NY 11354-5040
Phone (718) 939-1275

Other identifiers 2

IdentifierTypeStateIssuer
2203391OtherNYUNITED HEALTHCARE
02449296MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
018178NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Careone Physical Therapy, P.C. Physical Therapist PastSince Apr 8, 2009 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1629105754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15408 NORTHERN BLVD",
            "address_2": "2F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545040",
            "telephone_number": "718-939-1275",
            "fax_number": "718-939-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15408 NORTHERN BLVD",
            "address_2": "2F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545040",
            "telephone_number": "718-939-1275",
            "fax_number": "718-939-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HONG",
        "first_name": "JUWAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2203391",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02449296",
            "state": "NY"
        }
    ],
    "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 Apr 3, 2013; 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.