Individual provider Active NPI

Kang Seo

  • Physical Therapist
  • Hicksville, NY
National Provider Identifier
1659746451
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039791 Issued in NY
Practice address
111 W Old Country Rd
Suite 001
Hicksville, NY 11801-4036
Phone
(516) 433-4570
Fax
(516) 433-4578
NPI assigned
Dec 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2015

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 039791 NY Primary

Addresses

Primary practice location

111 W Old Country Rd
Suite 001
Hicksville, NY 11801-4036

Mailing address

111 W Old Country Rd
Suite 001
Hicksville, NY 11801-4036
Phone (516) 433-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160107003130 NY Practitioner - Physical Therapist in Private Practice 4880996800 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

44 Saint Marks PL
New York, NY 10003-8118
Phone (212) 529-5966

45 Crossways Park Dr W
Woodbury, NY 11797-2002
Phone (516) 621-1170

54 Central Park Rd
Plainview, NY 11803-2012
Phone (516) 870-2556

Merit-based Incentive Payment System (MIPS)

Final score
84.72 of 100Reported as individual
Quality
82.03
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True North Medical Group PC CurrentSince Jan 1, 2018 Accepting new patients
Home Physical Therapy Solutions P.C. Physical Therapist CurrentSince Nov 19, 2015 Accepting new patients
True North Medical Group PC Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince May 1, 2017 Accepting new patients
1 To 1 Concierge Physical Therapy P.C. Physical Therapist CurrentSince Jun 26, 2019 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Jun 1, 2019 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Bravo Occupational Therapy PC Physical Therapist PastSince Nov 19, 2015 Accepting new patients
True North Medical Group PC Past Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

111 W Old Country Rd
Ste 1
Hicksville, NY 11801
Phone (516) 433-4570

111 W Old Country Rd
Unit 1
Hicksville, NY 11801
Phone (516) 433-4570

444 Merrick Rd
Ste 360
Lynbrook, NY 11563
Phone (516) 536-3800

1728 Sunrise Hwy
Merrick, NY 11566
Phone (516) 992-4568

1983 Marcus Ave
Ste 119
New Hyde Park, NY 11042
Phone (516) 321-7526

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

36 Lincoln Ave
Fl 2
Rockville Ctr, NY 11570
Phone (516) 766-2176

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

45 Crossways Park Dr W
Woodbury, NY 11797
Phone (516) 422-8080

Organizations & group practices 9

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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1659746451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W OLD COUNTRY RD",
            "address_2": "SUITE 001",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014036",
            "telephone_number": "516-433-4570",
            "fax_number": "516-433-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W OLD COUNTRY RD",
            "address_2": "SUITE 001",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014036",
            "telephone_number": "516-433-4570",
            "fax_number": "516-433-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEO",
        "first_name": "KANG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.