Individual provider Active NPI

Yongha Kim, PT

  • Physical Therapist
  • Flushing, NY
National Provider Identifier
1679985535
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37344 Issued in NY
Practice address
15015 41St Ave
#2
Flushing, NY 11354-4917
Phone
(571) 835-5038
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294694 CA
Physical Therapist 225100000X 2305208592 VA
Physical Therapist 225100000X 37344 NY Primary

Addresses

Primary practice location

15015 41St Ave
#2
Flushing, NY 11354-4917

Mailing address

11405 Fulbourn CT
Rancho Cucamonga, CA 91730-8341
Phone (571) 835-5038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190415000443 CA Practitioner - Physical Therapist in Private Practice 6800100561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294694CAMDPhysical Therapist
37344NYMDPhysical Therapist
2305208592VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Naum Physical Therapy PC CurrentSince Sep 13, 2020 Accepting new patients
Choice Physical Therapy & Rehab PC Physical Therapist CurrentSince Jun 14, 2019 Accepting new patients

Locations

266 S Harvard Blvd
Ste 370
Los Angeles, CA 90004
Phone (213) 786-1088

3251 W 6th St
Ste 410
Los Angeles, CA 90020
Phone (213) 388-0182

520 S Virgil Ave
Ste 201
Los Angeles, CA 90020
Phone (213) 365-0023

18771 Colima Rd
Rowland Hghts, CA 91748
Phone (626) 269-0706

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1679985535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 FULBOURN CT",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308341",
            "telephone_number": "571-835-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 41ST AVE",
            "address_2": "#2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544917",
            "telephone_number": "571-835-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YONGHA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294694",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208592",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "37344",
            "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 Feb 21, 2019; 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.

Verify at the official NPI Registry.