Individual provider Active NPI

Geon Kim

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1649169905
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047265 Issued in NY
Practice address
13440 Cherry Ave # S2
Flushing, NY 11355-4796
Phone
(929) 669-9899
NPI assigned
Jul 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Physical Therapist 225100000X 047265 NY Primary

Addresses

Primary practice location

13440 Cherry Ave # S2
Flushing, NY 11355-4796

Mailing address

4355 164TH St FL 1
Flushing, NY 11358-3252
Phone (332) 269-5821

Other practice location 1

14359 37th Ave Fl 1
Flushing, NY 11354-5729
Phone (917) 563-5820

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
047265NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Synergy Physical Therapy P C Physical Therapist CurrentSince Jul 9, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1649169905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4355 164TH ST FL 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583252",
            "telephone_number": "332-269-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13440 CHERRY AVE # S2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113554796",
            "telephone_number": "929-669-9899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14359 37th Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113545729",
            "country_code": "US",
            "telephone_number": "917-563-5820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GEON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-01",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047265",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 14, 2026; 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.