Individual provider Active NPI

Kyung H Yoo, PT

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1831334945
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
021329-1 Issued in NY
Practice address
21315 33Rd Rd
Bayside, NY 11361-1508
Phone
(718) 229-4878
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

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 021329-1 NY Primary

Addresses

Primary practice location

21315 33Rd Rd
Bayside, NY 11361-1508

Mailing address

659 Larkfield Rd
Commack, NY 11725-1803
Phone (631) 486-1101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000417 NY Practitioner - Physical Therapist in Private Practice 6002956125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21315 33Rd Rd
Bayside, NY 11361-1508
Phone (718) 229-4878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021329-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Physical Therapy, Chiropractic & Acupuncture PLLC CurrentSince May 8, 2013 Accepting new patients
Grace Physical Therapy P.C. Past Accepting new patients
John Kim Acupunture P.C. Past Accepting new patients
Thetherapyspotforpediatric&Adultspeechphysical&Occupationaltherapypllc Physical Therapist PastSince Mar 1, 2008 Accepting new patients
The Therapy Spot, LLC Past Accepting new patients

Locations

21315 33rd Rd
Bayside, NY 11361
Phone (718) 224-2221

Organizations & group practices 5

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342742400000",
    "number": "1831334945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 LARKFIELD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251803",
            "telephone_number": "631-486-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21315 33RD RD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611508",
            "telephone_number": "718-229-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "KYUNG",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2012-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 20, 2012; 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.