Active NPI
Jin Kyoung Lee
- Physical Therapist
- Bayside, NY
National Provider Identifier
1932699170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 039137
- Practice address
- 20204 Rocky Hill Rd Apt DR2
Bayside, NY 11361-3007 - Phone
- (646) 706-2063
- NPI assigned
- May 14, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 039137 | NY | Primary |
Addresses
Primary practice location
20204 Rocky Hill Rd Apt DR2
Bayside, NY 11361-3007
Mailing address
20204 Rocky Hill Rd Apt DR2
Bayside, NY 11361-3007
Phone (646) 706-2063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 370048990 | Other | NY | LEARNER PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1932699170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20204 ROCKY HILL RD APT DR2",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613007",
"telephone_number": "646-706-2063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20204 ROCKY HILL RD APT DR2",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113613007",
"telephone_number": "646-706-2063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JIN KYOUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "039137",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LEARNER PERMIT",
"identifier": "370048990",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.