Individual provider Active NPI

Susan Kang

  • Physical Therapist
  • Little Neck, NY
National Provider Identifier
1902470412
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046027 Issued in NY
Practice address
25316 61St Ave Unit 1182
Little Neck, NY 11362-2431
Phone
(917) 685-3336
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 046027 NY Primary

Addresses

Primary practice location

25316 61St Ave Unit 1182
Little Neck, NY 11362-2431

Mailing address

25316 61St Ave Unit 1182
Little Neck, NY 11362-2431

Other practice location 1

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-7059

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004569 NY Practitioner - Physical Therapist in Private Practice 3274065370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Services of Flatiron PCGroup PAC ID 1759784085, 112 clinicians

Practice addresses (Care Compare)

138 5TH Ave
FL 2
New York, NY 10011-4367
Phone (212) 287-4257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046027NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blueprint Performance Physical Therapy Single Specialty Current Accepting new patients
Physical Therapy Services of Flatiron PC Single Specialty CurrentSince Aug 26, 2024 Accepting new patients

Locations

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1902470412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25316 61ST AVE UNIT 1182",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25316 61ST AVE UNIT 1182",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622431",
            "telephone_number": "917-685-3336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-7059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.