Active NPI
Cong Jie Li
- Physical Therapist
- Great Neck, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 048966
- Practice address
- 475 Northern Blvd Ste 11
Great Neck, NY 11021-4802 - Phone
- (516) 829-0030
- NPI assigned
- Oct 5, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 048966 | Primary |
Addresses
Primary practice location
475 Northern Blvd Ste 11
Great Neck, NY 11021-4802
Mailing address
475 Northern Blvd Ste 27
Great Neck, NY 11021-4802
Phone (516) 829-0030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
250 W 93Rd St
New York, NY 10025-7391
Phone (516) 829-0030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reddy Care Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
Locations
27278 Grand Central Pkwy
Floral Park, NY 11005
Phone (516) 344-0030
475 Northern Blvd
Ste 11
Great Neck, NY 11021
Phone (516) 344-0023
475 Northern Blvd
Ste 27
Great Neck, NY 11021
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
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": "1664928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1821713553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 NORTHERN BLVD STE 27",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110214802",
"telephone_number": "516-829-0030",
"fax_number": "516-466-7723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 NORTHERN BLVD STE 11",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110214802",
"telephone_number": "516-829-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "CONG JIE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-05",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "048966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.