Samuel Sangwon Yoo, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025179 Issued in NY

Practice address

3930 Richmond Ave Ste 200
Staten Island, NY 10312-5103

Phone

(646) 240-8453

NPI assigned

Apr 23, 2009

Last updated

Feb 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Broadway Physical Therapy

  • Orthopedic Physical Therapist
  • Newburgh, NY
  • NPI 1033950092
  NPD Authorized official
• Samuel Yoo Physical Therapy PC

  • Clinic/Center
  • Staten Island, NY
  • NPI 1124773940
  Authorized official Same address or phone
• Edison Medical PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1326311341
  NPD (past)
• Hartford Medical PC

  • Pain Medicine Physician
  • Brooklyn, NY
  • NPI 1285676635
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1891939625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125103",
            "telephone_number": "646-240-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125103",
            "telephone_number": "646-240-8453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Broadway Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125508272",
            "country_code": "US",
            "telephone_number": "646-240-8453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOO",
        "first_name": "SAMUEL",
        "middle_name": "SANGWON",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MEMBER PTAN FOR QUEENS",
            "identifier": "G400061606",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MEMBER PTAN FOR BROOKLYN, STATEN ISLAND, MANHATTAN",
            "identifier": "A400026932",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891939625",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zipporah Yoel, LMSW
• Arthy Yoga, MD
• Jeremy Yoo, DDS
• Jiyeon Helen Yoo, PH.D., BCBA-D
• Kyung Yoo, MD
• Hyun Ju Abigail Yoon
• Juyoung Yoon
• Kyung Yoon, MD
• Anthony Yorio Jr., DPT
• You & Me: a Guided Connection, LLC

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.