Individual provider Active NPI

Sung Jin Yoo

  • Physical Therapist
  • Jenkintown, PA
National Provider Identifier
1861701252
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020906 Issued in PA
Practice address
501 Washington LN Ste 302
Jenkintown, PA 19046-3148
Phone
(215) 554-2151
Fax
(215) 618-2506
NPI assigned
Oct 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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 PT020906 PA Primary
Physical Therapist 225100000X 10694 CO
Physical Therapist 225100000X 032629 NY

Addresses

Primary practice location

501 Washington LN Ste 302
Jenkintown, PA 19046-3148

Mailing address

501 Washington LN
Ste 302
Jenkintown, PA 19046-3148

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110523000339 PA Practitioner - Physical Therapist in Private Practice 0749466043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1349 W Cheltenham Ave
Suite 201
Elkins Park, PA 19027-3141
Phone (267) 763-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10694COMDPhysical Therapist
PT020906PAMDPhysical Therapist
032629NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dasarang Wellness Center Inc Physical Therapist Current Accepting new patients
Yoo Physical Therapy & Rehab Center Inc Physical Therapist CurrentSince Jan 1, 2011 Accepting new patients

Locations

1349 W Cheltenham Ave
Ste 201
Elkins Park, PA 19027
Phone (215) 782-1610

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": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1861701252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON LN",
            "address_2": "STE 302",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON LN STE 302",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463148",
            "telephone_number": "215-554-2151",
            "fax_number": "215-618-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "SUNG JIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-01",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020906",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "10694",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.