Individual provider Active NPI

Hyun Jong Yoon, D.P.T.

  • Orthopedic Physical Therapist
  • Bayside, NY
National Provider Identifier
1780922591
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
034532 Issued in NY
Practice address
215-19 39TH Ave
Bayside, NY 11361-2114
Phone
(718) 229-0707
Fax
(718) 229-0547
NPI assigned
Jan 29, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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 034532 NY Primary
Physical Therapist 225100000X NY

Addresses

Primary practice location

215-19 39TH Ave
Bayside, NY 11361-2114

Mailing address

215-19 39TH Ave
Bayside, NY 11361-2114
Phone (718) 229-0707

Other identifiers 2

IdentifierTypeStateIssuer
03757971MedicaidNY
A100092374OtherNYMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028000269 NY Practitioner - Physical Therapist in Private Practice 7719112838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21519 39TH Ave
Bayside, NY 11361-2114
Phone (718) 229-0707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034532NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nick Yoon Physical Therapy P.C. Physical Therapist CurrentSince Apr 15, 2015 Accepting new patients

Locations

21519 39th Ave
Bayside, NY 11361
Phone (718) 229-0707

139 Centre St
Ste 505
New York, NY 10013
Phone (212) 274-9870

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1780922591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215-19 39TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612114",
            "telephone_number": "718-229-0707",
            "fax_number": "718-229-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215-19 39TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612114",
            "telephone_number": "718-229-0707",
            "fax_number": "718-229-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "HYUN JONG",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "034532",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03757971",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A100092374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.