Active NPI
Tianyu Jia
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1679305452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1515 Surf Ave Apt Ph2A
Brooklyn, NY 11224-2405 - Phone
- (520) 307-1971
- NPI assigned
- Aug 19, 2024
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
1515 Surf Ave Apt Ph2A
Brooklyn, NY 11224-2405
Mailing address
1515 Surf Ave Apt Ph2A
Brooklyn, NY 11224-2405
Phone (520) 307-1971
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241007000890 | NY | Practitioner - Physical Therapist in Private Practice | 4082145610 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1679305452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 SURF AVE APT PH2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112242405",
"telephone_number": "520-307-1971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 SURF AVE APT PH2A",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112242405",
"telephone_number": "520-307-1971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIA",
"first_name": "TIANYU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.