Individual provider Active NPI

Kenneth Scott Young, PT, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1770732190
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
030648-1 Issued in NY
Practice address
244 E 84TH St
3Rd Floor
New York, NY 10028-2904
Phone
(212) 570-0209
NPI assigned
Sep 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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 030648-1 NY Primary

Addresses

Primary practice location

244 E 84TH St
3Rd Floor
New York, NY 10028-2904

Mailing address

244 E 84TH St
3Rd Floor
New York, NY 10028-2904
Phone (212) 570-0209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125001474 CA Practitioner - Physical Therapist in Private Practice 6709944853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Columbia University College of Physicians and Surgeons, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agile Physical Therapy IncGroup PAC ID 2163311556, 48 clinicians

Practice addresses (Care Compare)

3825 El Camino Real
Palo Alto, CA 94306-3324
Phone (650) 565-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030648-1NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agile Physical Therapy Inc CurrentSince Nov 15, 2018 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients

Locations

3825 El Camino Real
Palo Alto, CA 94306
Phone (856) 296-2860

1670 S Amphlett Blvd
Ste 123
San Mateo, CA 94402
Phone (650) 558-0247

Organizations & group practices 2

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1770732190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 E 84TH ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282904",
            "telephone_number": "212-570-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 E 84TH ST",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282904",
            "telephone_number": "212-570-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KENNETH",
        "middle_name": "SCOTT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030648-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.