Active NPI
Susan Kang
- Physical Therapist
- Little Neck, NY
National Provider Identifier
1902470412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 046027
- 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
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 | 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 046027 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blueprint Performance Physical Therapy | Single Specialty | Current | Accepting new patients |
| Physical Therapy Services of Flatiron PC | Single Specialty | Current | 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.
-
- Physical Therapy Clinic/Center
- New York, NY
- NPI 1134705676
Single Specialty
-
- Physical Therapist
- Little Neck, NY
- NPI 1154137131
Single Specialty
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.