Kyeonghwan Min, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040583 Issued in NY

Practice address

79 Mineola Blvd
Mineola, NY 11501-4006

Phone

(516) 366-4321

NPI assigned

Jul 18, 2018

Last updated

Aug 18, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Min Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Mineola, NY
  • NPI 1437709912

  Physical Therapist

  Medicare reassignment NPD Authorized official
• Rally Acupuncture P.C.

  • Acupuncturist
  • Mineola, NY
  • NPI 1215842414
  NPD (past) Authorized official
• Cornerstone Occupational Therapy PC

  • Occupational Therapist
  • Fresh Meadows, NY
  • NPI 1770373276

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1912483439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EASTERN DR",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110403439",
            "telephone_number": "718-414-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MINEOLA BLVD",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014006",
            "telephone_number": "516-366-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "KYEONGHWAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "007871",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "040583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie P. Miller, D.O.
• Lindsy Miller, M.D.
• Roseanna Miller, DO
• Shannon Jean Mills
• Min Physical Therapy PC
• Mineola Care Pharmacy Inc
• Mineola Clinical Laboratory, LLC
• Mineola Ear, Nose & Throat-Head & Neck Associates
• Mineola Eye Center Inc (20/20 Eye Care)
• Mineola Family Pharmacy Inc.

• Physical Therapist in Mineola, NY
• Providers in Mineola, 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 Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.